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Organization

MID-SOUTH CONVENIENT CARE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA FAYE OWEN (ADMIN)
(731) 286-1900
Entity
Organization

Contact information

Practice address
1445 US HIGHWAY 51 BYP E STE B, DYERSBURG, TN 38024-2127
(731) 286-1900
(731) 286-1900
Mailing address
1445 US HIGHWAY 51 BYP E STE B, DYERSBURG, TN 38024-2127
(731) 286-1900
(731) 286-1939

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
08/16/2017
Last updated
08/16/2017
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