| Lexington Primary Care | |
| 
					110 Tchula Street Lexington Primary Care Lexington MS 39095  | |
| (662) 834-1855 | |
| (662) 834-4953 | 
| Full Name | Lexington Primary Care | 
|---|---|
| Speciality | Clinic/center - Rural Health | 
| Location | 110 Tchula Street, Lexington, Mississippi | 
| Authorized Official Name and Position | Pauline Hathcock (NURSE PRACTITIONER) | 
| Authorized Official Contact | 6628341855 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lexington Primary Care Po Box 249 Lexington MS 39095-0249 Ph: (662) 834-1855  | Lexington Primary Care 110 Tchula Street Lexington Primary Care Lexington MS 39095 Ph: (662) 834-1855  | 
| NPI Number | 1972617876 | 
|---|---|
| Provider Enumeration Date | 08/18/2006 | 
| Last Update Date | 08/12/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972617876 | NPI | - | NPPES | 
| 0115646 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | R851692 (Mississippi) | Primary | 
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Mallory Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12572 Highway 12, Lexington, MS 39095 Phone: 662-235-5226  | |
Mallory Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17280 Highway 17, Lexington, MS 39095 Phone: 662-834-1857 Fax: 662-834-0531  | |
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