# FILLINGANE MEDICAL CLINIC, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sam Fillingane DO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386721546
- **Authorized official:** MRS. FREIDA L FILLINGANE (OFFICE MANAGER)
- **Authorized official phone:** (601) 906-4175

## Contact information

- **Practice address:** 1021 N FLOWOOD DRIVE, FLOWOOD, MS 39232-9533
- **Practice address phone:** (601) 664-2424
- **Practice address fax:** (601) 664-6675
- **Mailing address:** PO BOX 14153, JACKSON, MS 39236-4153
- **Mailing address phone:** (601) 664-2424
- **Mailing address fax:** (601) 664-6675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11114 | MS | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 01/28/2011