# MAGNOLIA INTERNAL MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1467567990
- **Authorized official:** EVAN L. SUMMERS M,D, (PRESIDENT)
- **Authorized official phone:** (601) 933-9696

## Contact information

- **Practice address:** 5 RIVER BEND PL, SUITE C, FLOWOOD, MS 39232-7618
- **Practice address phone:** (601) 933-9696
- **Mailing address:** PO BOX 321411, FLOWOOD, MS 39232-1411
- **Mailing address phone:** (601) 933-9696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 16638 | MS | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 07/13/2007