# ELITE MEDICAL, PLLC

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

## Provider details

- **NPI number:** 1871887661
- **Authorized official:** DR. ANNE DYE HAIRE D.O. (OWNER/PHYSICIAN)
- **Authorized official phone:** (662) 205-4652

## Contact information

- **Practice address:** 2633 TRACELAND DR, TUPELO, MS 38801-4238
- **Practice address phone:** (662) 205-4652
- **Practice address fax:** (662) 205-4651
- **Mailing address:** PO BOX 2484, TUPELO, MS 38803-2484
- **Mailing address phone:** (662) 205-4652
- **Mailing address fax:** (662) 205-4651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 16935 | MS | Yes |

## Other

- **Enumeration date:** 06/08/2011
- **Last updated:** 10/22/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00126275 | — | MS |