| Northside Hight School Clinic | |
|
1305 Martin Luther King Shelby MS 38774-2229 | |
| (662) 402-1098 | |
| Not Available |
| Full Name | Northside Hight School Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1305 Martin Luther King, Shelby, Mississippi |
| Authorized Official Name and Position | Nora Cecelia Gough-davis (FNP) |
| Authorized Official Contact | 6627543301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Hight School Clinic 1305 Martin Luther King Shelby MS 38774-2229 | Northside Hight School Clinic 1305 Martin Luther King Shelby MS 38774-2229 Ph: (662) 402-1098 |
| NPI Number | 1154038636 |
|---|---|
| Provider Enumeration Date | 11/03/2022 |
| Last Update Date | 11/03/2022 |
| Certification Date | 11/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154038636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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