Organization
COTTON PLANT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA J DECANTER CFNP (OWNER)
(662) 538-4111
Entity
Organization
Contact information
Practice address
100 COUNTY ROAD 714, BLUE MOUNTAIN, MS 38610-9743
(662) 538-4111
(662) 538-4128
Mailing address
100 COUNTY ROAD 714, BLUE MOUNTAIN, MS 38610-9743
(662) 538-4111
(662) 538-4128
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
R819565
MS
Other
Enumeration date
12/20/2012
Last updated
01/17/2013
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