Organization
NORTH MISSISSIPPI CLINICS, LLC
Active
Parent organization
NORTH MISSISSIPPI CLINICS, LLC
Other names
The Clinic at Walmart Oxford
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH MISSISSIPPI CLINICS, LLC
Authorized official
GERALD KIMBROUGH (DIRECTOR)
(662) 377-4685
Entity
Organization
Contact information
Practice address
2530 JACKSON AVE W, OXFORD, MS 38655-5403
(662) 513-6682
(662) 513-6684
Mailing address
2530 JACKSON AVE W, OXFORD, MS 38655-5403
(662) 513-6682
(662) 513-6684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302G086375
MEDICARE GROUP
MS
Enumeration date
10/24/2011
Last updated
02/06/2023
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