Organization
P&S PRIMARY CARE, PLLC
Active
Parent organization
P & S CLINIC OB-GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
P & S CLINIC OB-GYN
Authorized official
MR. TIMOTHY WAYNE BODEN CMPE (EXECUTIVE DIRECTOR)
(662) 256-9331
Entity
Organization
Contact information
Practice address
900 EARL FRYE BLVD STE A, AMORY, MS 38821-5507
(662) 256-9331
Mailing address
900 EARL FRYE BLVD STE A, AMORY, MS 38821-5507
(662) 256-9331
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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