| Sebastopol Clinic | |
|
1488 Hwy 487 Sebastopol MS 39359 | |
| (601) 625-7140 | |
| (601) 625-7199 |
| Full Name | Sebastopol Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1488 Hwy 487, Sebastopol, Mississippi |
| Authorized Official Name and Position | Tammy L Mcphail (MIS INSURANCE COORDINATOR) |
| Authorized Official Contact | 6016257140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sebastopol Clinic Po Box 142 Sebastopol MS 39359 Ph: (601) 625-7140 | Sebastopol Clinic 1488 Hwy 487 Sebastopol MS 39359 Ph: (601) 625-7140 |
| NPI Number | 1699721209 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941103717 |
|---|---|
| Medicare Enrollment ID | O20100629000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699721209 | NPI | - | NPPES |
| DA1146 | Other | RAILROAD MEDICARE | |
| 09010024 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Hometown Health And Wellness, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17509 Highway 21, Sebastopol, MS 39359 Phone: 601-287-8177 Fax: 833-934-3464 | |
Main Street Medical Clinic Of Sebastopol Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17509 Hwy 21, Sebastopol, MS 39359 Phone: 601-625-9818 Fax: 601-625-9904 |