| South Marion Primary Care Clinic-sulligent | |
|
1390 Walnut St Sulligent AL 35586-3841 | |
| (205) 698-7111 | |
| (205) 698-0516 |
| Full Name | South Marion Primary Care Clinic-sulligent |
|---|---|
| Speciality | Clinic/Center |
| Location | 1390 Walnut St, Sulligent, Alabama |
| Authorized Official Name and Position | Bruce Toppin (CORPORATE SECRETARY) |
| Authorized Official Contact | 6623774229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Marion Primary Care Clinic-sulligent 808 Varsity Dr Tupelo MS 38801-4613 Ph: (662) 377-3868 | South Marion Primary Care Clinic-sulligent 1390 Walnut St Sulligent AL 35586-3841 Ph: (205) 698-7111 |
| NPI Number | 1194513986 |
|---|---|
| Provider Enumeration Date | 04/30/2025 |
| Last Update Date | 04/30/2025 |
| Certification Date | 04/30/2025 |
| Medicare PECOS PAC ID | 5193213650 |
|---|---|
| Medicare Enrollment ID | O20251124004013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194513986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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