Organization
EAST MAIN FAMILY MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY RODGERS FNP (OWNER/NURSE PRACTITIONER)
(662) 350-3550
Entity
Organization
Contact information
Practice address
1424 E MAIN ST, TUPELO, MS 38804-2956
(662) 842-4877
Mailing address
1424 E MAIN ST, TUPELO, MS 38804-2956
(662) 350-3550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/13/2013
Last updated
09/08/2020
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