Organization
FILLINGANE MEDICAL CLINIC, PA
Active
Other names
Sam Fillingane DO
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FREIDA L FILLINGANE (OFFICE MANAGER)
(601) 906-4175
Entity
Organization
Contact information
Practice address
1021 N FLOWOOD DRIVE, FLOWOOD, MS 39232-9533
(601) 664-2424
(601) 664-6675
Mailing address
PO BOX 14153, JACKSON, MS 39236-4153
(601) 664-2424
(601) 664-6675
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11114
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116048
—
MS
Enumeration date
11/01/2006
Last updated
01/28/2011
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