Organization
GILMORE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS DEDEAUX (CLINIC ADMINISTRATOR)
(662) 256-7112
Entity
Organization
Contact information
Practice address
900 EARL FRYE BLVD STE C, AMORY, MS 38821-5507
(662) 256-6227
Mailing address
123 MAIN ST N, AMORY, MS 38821-3416
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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