| Patriot Healthcare Of Mississippi, Llc | |
|
4800 Lakeland Drive Flowood MS 39232 | |
| (228) 563-4787 | |
| Not Available |
| Full Name | Patriot Healthcare Of Mississippi, Llc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 4800 Lakeland Drive, Flowood, Mississippi |
| Authorized Official Name and Position | David A. Culver (ADMINISTRATOR) |
| Authorized Official Contact | 9048254368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patriot Healthcare Of Mississippi, Llc 100 Arricola Avenue St. Augustine FL 32080 Ph: (904) 825-4368 | Patriot Healthcare Of Mississippi, Llc 4800 Lakeland Drive Flowood MS 39232 Ph: (228) 563-4787 |
| NPI Number | 1104395565 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 11/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104395565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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