# BELMONT MEDICAL CLINIC LLC

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

## Provider details

- **NPI number:** 1619459922
- **Authorized official:** HEATHER L EDMONDSON FNP (PROVIDER/OWNER)
- **Authorized official phone:** (662) 454-3401

## Contact information

- **Practice address:** 102 3RD ST, BELMONT, MS 38827-7601
- **Practice address phone:** (662) 454-3401
- **Mailing address:** PO BOX 813, BELMONT, MS 38827-0813
- **Mailing address phone:** (662) 454-3401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2018
- **Last updated:** 09/17/2018