Organization
TENN-TOM MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE WHITEHEAD NP (MANAGING NURSE PRACTITIONER)
(662) 427-4040
Entity
Organization
Contact information
Practice address
369 HIGHWAY 72, BURNSVILLE, MS 38833-9320
(662) 427-4040
(662) 427-4041
Mailing address
PO BOX 214, BURNSVILLE, MS 38833-0214
(662) 427-4040
(662) 427-4041
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
04/21/2022
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