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Organization
WALLEY CLINIC PA
Active
Organization
WALLEY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELETHA JANE JENKINS (CEO)
(601) 735-2401
Entity
Organization
Contact information
Practice address
920 MATTHEW DR, STE A, WAYNESBORO, MS 39367-2567
(601) 735-2401
(601) 735-5205
Mailing address
920 MATTHEW DR, STE A, WAYNESBORO, MS 39367-2567
(601) 735-2401
(601) 735-5205
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/31/2005
Last updated
02/27/2008
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