| Kids Klinic LLC | |
|
200 Country Club Rd Carriere MS 39426-9037 | |
| (601) 799-4777 | |
| Not Available |
| Full Name | Kids Klinic LLC |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 200 Country Club Rd, Carriere, Mississippi |
| Authorized Official Name and Position | Ahmad Haidar (OWNER) |
| Authorized Official Contact | 6017994777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Klinic LLC 200 Country Club Rd Carriere MS 39426-9037 Ph: (601) 799-4777 | Kids Klinic LLC 200 Country Club Rd Carriere MS 39426-9037 Ph: (601) 799-4777 |
| NPI Number | 1215277652 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 12/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215277652 | NPI | - | NPPES |
| 00112453 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 13678 (Mississippi) | Primary |
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