# KDMC PHYSICIAN CLINICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KINGS DAUGHTERS MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1861739161
- **Legal business name:** KINGS DAUGHTERS MEDICAL CENTER
- **Authorized official:** MR. SCOTT CHRISTENSEN (CEO)
- **Authorized official phone:** (601) 835-9488

## Contact information

- **Practice address:** 950 BROOKWAY BLVD, BROOKHAVEN, MS 39601-2644
- **Practice address phone:** (601) 823-5103
- **Practice address fax:** (601) 823-3514
- **Mailing address:** 427 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2350
- **Mailing address phone:** (601) 833-6011
- **Mailing address fax:** (601) 823-2206

## Taxonomy

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

## Other

- **Enumeration date:** 01/08/2013
- **Last updated:** 03/27/2023