| Thaxton Family Medical Clinic Llc | |
|
11145 Highway 6 W Thaxton MS 38871-9024 | |
| (662) 489-8500 | |
| (662) 489-8600 |
| Full Name | Thaxton Family Medical Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 11145 Highway 6 W, Thaxton, Mississippi |
| Authorized Official Name and Position | Kevin Floyd (PROVIDER/MANAGING MEMBER) |
| Authorized Official Contact | 6622137890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thaxton Family Medical Clinic Llc 11145 Highway 6 W Thaxton MS 38871-9024 Ph: (662) 489-8500 | Thaxton Family Medical Clinic Llc 11145 Highway 6 W Thaxton MS 38871-9024 Ph: (662) 489-8500 |
| NPI Number | 1124505912 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 7315298973 |
|---|---|
| Medicare Enrollment ID | O20180920000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124505912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 901818 (Mississippi) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | 901818 (Mississippi) | Primary |
| Provider Name | Kevin A Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174075220 PECOS PAC ID: 0345524021 Enrollment ID: I20170223001950 |
Thaxton Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11145 Highway 6 West, Thaxton, MS 38871 Phone: 662-489-8500 |