# ADVANCE MEDICAL HOUSE CALLS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advance Medical House Calls & Family Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104318286
- **Authorized official:** TYE ROLLINS (MANAGER)
- **Authorized official phone:** (601) 397-4079

## Contact information

- **Practice address:** 299 HIGHWAY 51 STE F1, RIDGELAND, MS 39157-3424
- **Practice address phone:** (601) 397-4079
- **Practice address fax:** (601) 398-2149
- **Mailing address:** PO BOX 1404, RIDGELAND, MS 39158-1404
- **Mailing address phone:** (601) 397-4079
- **Mailing address fax:** (601) 398-2149

## Taxonomy

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

## Other

- **Enumeration date:** 06/04/2018
- **Last updated:** 08/17/2018