# INTERVENTIONAL DIABETES CENTER, LLC

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

## Provider details

- **NPI number:** 1649747825
- **Authorized official:** MAURICE HAMPTON (OWNER)
- **Authorized official phone:** (901) 791-1711

## Contact information

- **Practice address:** 20735 HIGHWAY 12, LEXINGTON, MS 39095-8266
- **Practice address phone:** (601) 594-7346
- **Mailing address:** 20735 HIGHWAY 12, LEXINGTON, MS 39095-8266
- **Mailing address phone:** (901) 791-1711

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2018
- **Last updated:** 05/06/2025