| The Clinic At Farmers Medshoppe | |
|
62 Highway 587 Foxworth MS 39483 | |
| (601) 424-3540 | |
| (601) 424-3544 |
| Full Name | The Clinic At Farmers Medshoppe |
|---|---|
| Speciality | Clinic/Center |
| Location | 62 Highway 587, Foxworth, Mississippi |
| Authorized Official Name and Position | Clayton A. Farmer (OWNER) |
| Authorized Official Contact | 6014243540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Clinic At Farmers Medshoppe P.o. Box 669 Foxworth MS 39483 Ph: (601) 424-3540 | The Clinic At Farmers Medshoppe 62 Highway 587 Foxworth MS 39483 Ph: (601) 424-3540 |
| NPI Number | 1487972568 |
|---|---|
| Provider Enumeration Date | 05/13/2010 |
| Last Update Date | 10/09/2013 |
| Medicare PECOS PAC ID | 2466584982 |
|---|---|
| Medicare Enrollment ID | O20100720000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487972568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Mississippi) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (Mississippi) | Primary |
| Provider Name | Johnny R Bullock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043268709 PECOS PAC ID: 3971562976 Enrollment ID: I20041006000254 |
| Provider Name | Berthold Beisel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174546345 PECOS PAC ID: 4082704291 Enrollment ID: I20071212000061 |
| Provider Name | Michael W Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033223995 PECOS PAC ID: 8224128384 Enrollment ID: I20071213000461 |
| Provider Name | John E Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699064659 PECOS PAC ID: 0648455303 Enrollment ID: I20110425000422 |
| Provider Name | Melissa R Tolar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023346137 PECOS PAC ID: 9638311764 Enrollment ID: I20130820000171 |
| Provider Name | Suzanne Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457504730 PECOS PAC ID: 6305152026 Enrollment ID: I20150826000981 |
| Provider Name | Garrett L Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477933745 PECOS PAC ID: 5597073635 Enrollment ID: I20151009000242 |
| Provider Name | Lori S Beisel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235683665 PECOS PAC ID: 9537444377 Enrollment ID: I20170318000045 |
| Provider Name | Lloyd Clifton Stringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386206068 PECOS PAC ID: 3577928506 Enrollment ID: I20230427000151 |