| Pine Grove Association | |
|
1134 Barnes Rd Canton MS 39046 | |
| (601) 761-9424 | |
| Not Available |
| Full Name | Pine Grove Association |
|---|---|
| Speciality | General Practice |
| Location | 1134 Barnes Rd, Canton, Mississippi |
| Authorized Official Name and Position | Angela Carson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6019551132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Grove Association 1134 Barnes Rd Canton MS 39046-0036 Ph: () - | Pine Grove Association 1134 Barnes Rd Canton MS 39046 Ph: (601) 761-9424 |
| NPI Number | 1871316257 |
|---|---|
| Provider Enumeration Date | 11/05/2024 |
| Last Update Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871316257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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