Organization
THAXTON MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH BROOKE HOOKER RT (OWNER/)
(662) 489-8500
Entity
Organization
Contact information
Practice address
11145 HIGHWAY 6 WEST, THAXTON, MS 38871
(662) 489-8500
Mailing address
PO BOX 99, THAXTON, MS 38871-0099
(662) 489-8500
(662) 489-8600
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
23667
MS
363L00000X
Nurse Practitioner
901698
MS
363L00000X
Nurse Practitioner
R850403
MS
Other
Enumeration date
09/01/2016
Last updated
11/16/2016
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