| Southern Remedy Family Medicine | |
|
3000 Plaza Dr Ste C Tylertown MS 39667-9227 | |
| (601) 803-5676 | |
| (601) 803-5677 |
| Full Name | Southern Remedy Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 3000 Plaza Dr Ste C, Tylertown, Mississippi |
| Authorized Official Name and Position | Chelsea Hill (FNP-C) |
| Authorized Official Contact | 6013031111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Remedy Family Medicine 3000 Plaza Dr Ste C Tylertown MS 39667-9227 Ph: (601) 303-1111 | Southern Remedy Family Medicine 3000 Plaza Dr Ste C Tylertown MS 39667-9227 Ph: (601) 803-5676 |
| NPI Number | 1639944416 |
|---|---|
| Provider Enumeration Date | 11/21/2023 |
| Last Update Date | 11/21/2023 |
| Medicare PECOS PAC ID | 9234572322 |
|---|---|
| Medicare Enrollment ID | O20240206000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639944416 | NPI | - | NPPES |
| 1235646688 | Medicaid | MS | |
| 1922559772 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Bruce Eric Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922559772 PECOS PAC ID: 7911285614 Enrollment ID: I20161101000950 |
| Provider Name | Chelsea K Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235646688 PECOS PAC ID: 6800157546 Enrollment ID: I20180221000910 |
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