| Magnolia Gastroenterology Clinic, Llc | |
|
3050 Corder Drive Magnolia Gastroenterology Clinic, Llc Corinth MS 38834 | |
| (662) 284-9902 | |
| (662) 284-9904 |
| Full Name | Magnolia Gastroenterology Clinic, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3050 Corder Drive, Corinth, Mississippi |
| Authorized Official Name and Position | Fredrick Alvin Corder (OWNER/PHYSICIAN/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6622849902 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Gastroenterology Clinic, Llc Po Box 600 Corinth MS 38835-0600 Ph: (662) 284-9902 | Magnolia Gastroenterology Clinic, Llc 3050 Corder Drive Magnolia Gastroenterology Clinic, Llc Corinth MS 38834 Ph: (662) 284-9902 |
| NPI Number | 1518941731 |
|---|---|
| Provider Enumeration Date | 12/01/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800844507 |
|---|---|
| Medicare Enrollment ID | O20050110000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518941731 | NPI | - | NPPES |
| 09016046 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Allene R Jolly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538106802 PECOS PAC ID: 8426036393 Enrollment ID: I20040708000976 |
| Provider Name | Cheryl Burcham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538270996 PECOS PAC ID: 6103854492 Enrollment ID: I20050728000500 |
| Provider Name | Tara W Wadkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265563365 PECOS PAC ID: 7719085687 Enrollment ID: I20070531000519 |
| Provider Name | Frederick A Corder |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710961982 PECOS PAC ID: 8527016229 Enrollment ID: I20100915000696 |
| Provider Name | Alicia M Nabors |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609125269 PECOS PAC ID: 8426206111 Enrollment ID: I20130320000288 |
| Provider Name | Amy Massengill Sanders |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689923401 PECOS PAC ID: 0143479998 Enrollment ID: I20161013000941 |
| Provider Name | Jessica Star Harkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295377968 PECOS PAC ID: 5698108900 Enrollment ID: I20191127000460 |
| Provider Name | Carrie Wilbanks Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467078790 PECOS PAC ID: 2567885817 Enrollment ID: I20200706002113 |
Mrh Medical Group, Corinth Alcorn Dr. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 508 Alcorn Dr, Corinth, MS 38834 Phone: 663-396-4733 | |
Magnolia Physician Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 Alcorn Dr, Corinth, MS 38834 Phone: 662-293-7618 | |
Magnolia Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 703 Alcorn Dr, Suite 109, Corinth, MS 38834 Phone: 662-286-1499 Fax: 662-286-9041 | |
Magnolia Infectious Disease Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 Alcorn Dr, Corinth, MS 38834 Phone: 662-293-1000 | |
Magnolia Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Norman Rd, Corinth, MS 38834 Phone: 662-293-1000 | |
Magnolia Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3704 Highway 72 W, Corinth, MS 38834 Phone: 662-665-8041 Fax: 662-665-8049 | |
Crossroads Family Health Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2427 Proper St, Corinth, MS 38834 Phone: 662-286-2300 Fax: 662-286-7010 |