# EUDORA MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eudora Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255043493
- **Authorized official:** MS. AMY M. PERKINS FNP-C (OWNER)
- **Authorized official phone:** (662) 589-6290

## Contact information

- **Practice address:** 8995 W COMMERCE ST STE 4, HERNANDO, MS 38632-6812
- **Practice address phone:** (662) 589-6290
- **Practice address fax:** (662) 649-6085
- **Mailing address:** 8995 W COMMERCE ST STE 4, HERNANDO, MS 38632-6812
- **Mailing address phone:** (662) 589-6290
- **Mailing address fax:** (662) 649-6085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2022
- **Last updated:** 03/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03003882 | — | MS |
| 01 | — | 879057 | MS NURSING/NP LICENSE | MS |