| Psp Medical Clinic Llc | |
|
1171 Hart St Canton MS 39046-4805 | |
| (601) 859-9888 | |
| (601) 859-9966 |
| Full Name | Psp Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1171 Hart St, Canton, Mississippi |
| Authorized Official Name and Position | Neelam Goel (MANAGER) |
| Authorized Official Contact | 6018599888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psp Medical Clinic Llc P.o. Box 607 Canton MS 39157 Ph: (601) 859-9888 | Psp Medical Clinic Llc 1171 Hart St Canton MS 39046-4805 Ph: (601) 859-9888 |
| NPI Number | 1932144243 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 04/06/2021 |
| Medicare PECOS PAC ID | 6406859446 |
|---|---|
| Medicare Enrollment ID | O20060814000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932144243 | NPI | - | NPPES |
| 25D1052898 | Other | MS | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 15405 (Mississippi) | Primary |
| Provider Name | Parvesh K Goel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548219082 PECOS PAC ID: 7416998760 Enrollment ID: I20060814000136 |
| Provider Name | Verena T Valley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679508097 PECOS PAC ID: 3577652130 Enrollment ID: I20071204000693 |
| Provider Name | Hannah Poyner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295239218 PECOS PAC ID: 9032472535 Enrollment ID: I20180416001612 |
| Provider Name | Kristy Lynn Staten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093321192 PECOS PAC ID: 4385040237 Enrollment ID: I20210901002307 |
| Provider Name | Xiaoming Hester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902575830 PECOS PAC ID: 7517353493 Enrollment ID: I20220331002467 |
| Provider Name | Caraline Putnam Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992319321 PECOS PAC ID: 6507236858 Enrollment ID: I20230117000504 |
| Provider Name | Reta Cozette Chandler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265249288 PECOS PAC ID: 7911436282 Enrollment ID: I20250131000359 |
Mallory Community Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 276 Nissan Parkway, Building C, Suite 100, Canton, MS 39046 Phone: 601-855-5275 Fax: 601-859-3253 | |
G A Carmichael Family Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1668 W Peace St, Canton, MS 39046 Phone: 601-859-5213 Fax: 601-859-8771 | |
Mea Primary Care Plus Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Southlake Cir, Canton, MS 39046 Phone: 601-859-8550 | |
G A Carmichael Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1421 E Peace St Ste B, Canton, MS 39046 Phone: 601-855-2516 Fax: 601-859-8771 | |
Psp Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1171 Hart St, Canton, MS 39046 Phone: 601-859-9888 Fax: 601-859-9004 | |
Everycare Express Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Feather Ln, Suite E, Canton, MS 39046 Phone: 601-859-0140 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Southlake Cir, Canton, MS 39046 Phone: 601-859-8550 |