| Ochsner Health Center-dekalb | |
|
30 Ponderosa Ave De Kalb MS 39328-9104 | |
| (601) 743-4626 | |
| (601) 743-2133 |
| Full Name | Ochsner Health Center-dekalb |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 Ponderosa Ave, De Kalb, Mississippi |
| Authorized Official Name and Position | Don Larkin Kennedy (REGIONAL CEO) |
| Authorized Official Contact | 6017039614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ochsner Health Center-dekalb Dept 3019, P O Box 1000 Memphis TN 38148-3019 Ph: (601) 213-3010 | Ochsner Health Center-dekalb 30 Ponderosa Ave De Kalb MS 39328-9104 Ph: (601) 743-4626 |
| NPI Number | 1912348616 |
|---|---|
| Provider Enumeration Date | 07/10/2013 |
| Last Update Date | 04/26/2023 |
| Medicare PECOS PAC ID | 5991985012 |
|---|---|
| Medicare Enrollment ID | O20130816000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912348616 | NPI | - | NPPES |
| 003186256 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Kemper Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 Birch St, De Kalb, MS 39328 Phone: 601-743-2642 Fax: 601-965-0324 |