Organization
NORTH MISSISSIPPI MEDICAL CLINICS INC
Active
Other names
Ecru Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD KIMBROUGH (MANAGER)
(662) 377-4685
Entity
Organization
Contact information
Practice address
202 MAIN STREET, ECRU, MS 38841
(662) 489-4345
(662) 489-8975
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014823
—
MS
Enumeration date
08/31/2006
Last updated
08/22/2020
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