Organization
ADULTS & CHILDREN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY C. THORNTON PNP ANP (OWNER)
(662) 348-2002
Entity
Organization
Contact information
Practice address
571 MITCHELL RD, SUITE C, GUNTOWN, MS 38849-0156
(662) 348-2002
(662) 348-2001
Mailing address
PO BOX 156, GUNTOWN, MS 38849-0156
(662) 348-2002
(662) 348-2001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R519715
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016058
—
MS
Enumeration date
02/05/2007
Last updated
05/06/2013
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