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Organization

SILVER MEDICAL ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIM ANTOINETTE MITCHELL-SILVER M.D. (OWNER/ADMINISTRATOR)
(769) 242-2020
Entity
Organization

Contact information

Practice address
814 S HAUGH AVE, BOX 1675, PICAYUNE, MS 39466-5350
(769) 242-2020
(769) 242-2023
Mailing address
814 S HAUGH AVE, PICAYUNE, MS 39466-5350
(769) 242-2020
(769) 242-2023

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1095115
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00606725
MS
05
02274570
MS
Enumeration date
09/01/2016
Last updated
06/11/2019
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