# INDIAN SPRINGS MEDICAL CLINIC LLC

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

## Provider details

- **NPI number:** 1295493682
- **Authorized official:** ADAM JERRID CUMBERLAND (OPERATIONS MANAGER)
- **Authorized official phone:** (601) 782-9997

## Contact information

- **Practice address:** 517 CENTER AVE N, PHILADELPHIA, MS 39350-2552
- **Practice address phone:** (601) 656-1440
- **Practice address fax:** (601) 782-5655
- **Mailing address:** 41 S HALL RD, MORTON, MS 39117-8057
- **Mailing address phone:** (601) 782-9997
- **Mailing address fax:** (601) 782-5655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/02/2021
- **Last updated:** 12/02/2021