# LUCEDALE URGENT CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lucedale Urgent Care, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700372034
- **Authorized official:** BRIDGOT PETERS (BILLING DIRECTOR)
- **Authorized official phone:** (251) 445-7618

## Contact information

- **Practice address:** 103 W FRONTAGE RD STE C, LUCEDALE, MS 39452-5836
- **Practice address phone:** (251) 633-0123
- **Practice address fax:** (251) 445-3722
- **Mailing address:** 103 W FRONTAGE RD STE C, LUCEDALE, MS 39452-5836
- **Mailing address phone:** (601) 947-9596
- **Mailing address fax:** (251) 445-3722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/10/2018
- **Last updated:** 06/06/2023