Organization
MAGNOLIA MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTYN BUMPERS PHARM. D. (PHARMACIST)
(601) 441-4400
Entity
Organization
Contact information
Practice address
431 BROAD ST, COLUMBIA, MS 39429-3056
(601) 736-8212
Mailing address
79 HIGHPOINTE DR, HATTIESBURG, MS 39402-9536
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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