Organization
MISSISSIPPI MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY BULLOCK NP (NP MANAGING PARTNER)
(601) 452-7080
Entity
Organization
Contact information
Practice address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Mailing address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
04/25/2022
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