Organization
MS MAGNOLIA MEDICAL,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY A RATCLIFF (CREDENTIALING)
(601) 433-5679
Entity
Organization
Contact information
Practice address
516 N MAGNOLIA ST, LAUREL, MS 39440-3559
(601) 422-5990
Mailing address
516 N MAGNOLIA ST, LAUREL, MS 39440-3559
(601) 342-5901
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
07/22/2022
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