Organization
FAMILY PRACTICE CLINIC OF WATER VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DRAGICA MILICEVIC MD (FAMILY PRACTICE)
(662) 473-4050
Entity
Organization
Contact information
Practice address
606 SO MAIN ST, WATER VALLEY, MS 38965
(662) 473-4050
(662) 473-4191
Mailing address
PO BOX 643, WATER VALLEY, MS 38965
(662) 473-4050
(662) 473-4191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18660
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01265531
—
MS
Enumeration date
10/23/2006
Last updated
08/12/2008
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