Organization
SEGUE HEALTH OF MISSISSIPPI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE CLARK (OPERATIONS DIRECTOR)
(901) 626-3515
Entity
Organization
Contact information
Practice address
232 MARKET ST, FLOWOOD, MS 39232-3339
(888) 551-2538
(844) 364-2629
Mailing address
765 WOODLAND TRACE LN, CORDOVA, TN 38018-6609
(901) 626-3515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02923052
—
MS
Enumeration date
05/16/2017
Last updated
05/03/2021
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