# MAIN STREET MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013340892
- **Authorized official:** EMILY DAVIS PERKINS (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (662) 803-5318

## Contact information

- **Practice address:** 106 W MAIN ST, LOUISVILLE, MS 39339-2620
- **Practice address phone:** (662) 803-5318
- **Mailing address:** 106 W MAIN ST, LOUISVILLE, MS 39339-2620
- **Mailing address phone:** (662) 803-5318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2013
- **Last updated:** 08/16/2013