# DURANT PRIMARY CARE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DURANT PRIMARY CARE CLINIC
- **Other names:** LEXINGTON MEDICAL CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942536552
- **Legal business name:** DURANT PRIMARY CARE CLINIC
- **Authorized official:** MS. SHELIA ANN SNOW (OFFICE MANAGER)
- **Authorized official phone:** (662) 834-1961

## Contact information

- **Practice address:** 22741 BOWLING GREEN RD, LEXINGTON, MS 39095
- **Practice address phone:** (662) 834-1961
- **Practice address fax:** (662) 834-1962
- **Mailing address:** 22741 HWY 12 BOWLING GREEN RD, LEXINGTON, MS 39095
- **Mailing address phone:** (662) 834-1961
- **Mailing address fax:** (662) 834-1962

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 14192 | MS | Yes |

## Other

- **Enumeration date:** 11/02/2009
- **Last updated:** 03/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00115622 | — | MS |