# RANKIN PRIMARY CARE CLINIC, PA

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

## Provider details

- **NPI number:** 1467625665
- **Authorized official:** THOMAS L ELLINGSON MD (OWNER)
- **Authorized official phone:** (601) 824-1491

## Contact information

- **Practice address:** 103 SERVICE DR, BRANDON, MS 39042-2401
- **Practice address phone:** (601) 824-1491
- **Practice address fax:** (601) 825-9504
- **Mailing address:** PO BOX 1959, BRANDON, MS 39043-1959
- **Mailing address phone:** (601) 824-1491
- **Mailing address fax:** (601) 825-9504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 16492 | MS | Yes |

## Other

- **Enumeration date:** 04/08/2008
- **Last updated:** 04/08/2008