| Main Street Medical Clinic Of Sebastopol | |
|
17509 Hwy 21 Sebastopol MS 39359-0000 | |
| (601) 625-9818 | |
| (601) 625-9904 |
| Full Name | Main Street Medical Clinic Of Sebastopol |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 17509 Hwy 21, Sebastopol, Mississippi |
| Authorized Official Name and Position | Joseph S Mcnulty (CEO) |
| Authorized Official Contact | 6018496440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Medical Clinic Of Sebastopol 17509 Hwy 21 Sebastopol MS 39359-0000 Ph: (601) 625-9818 | Main Street Medical Clinic Of Sebastopol 17509 Hwy 21 Sebastopol MS 39359-0000 Ph: (601) 625-9818 |
| NPI Number | 1760778609 |
|---|---|
| Provider Enumeration Date | 06/20/2011 |
| Last Update Date | 12/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760778609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Hometown Health And Wellness, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17509 Highway 21, Sebastopol, MS 39359 Phone: 601-287-8177 Fax: 833-934-3464 | |
Sebastopol Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1488 Hwy 487, Sebastopol, MS 39359 Phone: 601-625-7140 Fax: 601-625-7199 |