Organization
PSP MEDICAL CLINIC
Active
Organization
PSP MEDICAL CLINIC
Active
Other names
Magnolia Medical Clinics/Gluckstadt, Magnolia Medical Clinics, Gluckstadt Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PARVESH K. GOEL MD (MD)
(601) 707-5621
Entity
Organization
Contact information
Practice address
1082A GLUCKSTADT RD, GLUCKSTADT, MS 39110-7243
(601) 707-5621
Mailing address
PO BOX 607, CANTON, MS 39046-0607
(601) 859-9888
(601) 859-9966
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25D1087086
CLIA
MS
Enumeration date
09/28/2012
Last updated
06/08/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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