# GREENWOOD COMPREHENSIVE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1225172562
- **Authorized official:** DR. VALENCIA PATRICE MARTIN M.D. (VICE PRESIDENT)
- **Authorized official phone:** (662) 455-6767

## Contact information

- **Practice address:** 517 HIGHWAY 82 W, GREENWOOD, MS 38930-5030
- **Practice address phone:** (662) 455-6767
- **Practice address fax:** (662) 455-1774
- **Mailing address:** PO BOX 1179, GREENWOOD, MS 38935-1179
- **Mailing address phone:** (662) 455-6767
- **Mailing address fax:** (662) 455-1774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10298 | MS | Yes |
| 207R00000X | Internal Medicine Physician | 10035 | MS | — |

## Other

- **Enumeration date:** 02/19/2007
- **Last updated:** 05/22/2024