| Premise Health Of Mississippi Medical Pc | |
| 
					1200 Magnolia Way Blue Springs MS 38828-6000  | |
| (662) 317-4100 | |
| (662) 317-4103 | 
| Full Name | Premise Health Of Mississippi Medical Pc | 
|---|---|
| Speciality | Clinic/center - Multi-specialty | 
| Location | 1200 Magnolia Way, Blue Springs, Mississippi | 
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) | 
| Authorized Official Contact | 2164799063 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Premise Health Of Mississippi Medical Pc 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () -  | Premise Health Of Mississippi Medical Pc 1200 Magnolia Way Blue Springs MS 38828-6000 Ph: (662) 317-4100  | 
| NPI Number | 1669781852 | 
|---|---|
| Provider Enumeration Date | 10/05/2010 | 
| Last Update Date | 10/13/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1669781852 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |