# CHOCTAW COUNTY

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

## Provider details

- **NPI number:** 1326350240
- **Authorized official:** MR. THOMAS F HIGGINS SR. (PRESIDENT OF THE BOARD)
- **Authorized official phone:** (662) 285-6329

## Contact information

- **Practice address:** 119 WEST CHERRY STREET, ACKERMAN, MS 39735-0000
- **Practice address phone:** (601) 849-1682
- **Practice address fax:** (601) 849-1969
- **Mailing address:** 119 WEST CHERRY STREET, ACKERMAN, MS 39735-0000
- **Mailing address phone:** (601) 849-1682
- **Mailing address fax:** (601) 849-1969

## Taxonomy

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

## Other

- **Enumeration date:** 07/08/2010
- **Last updated:** 07/08/2010