Organization
NORTH MISSISSIPPI MEDICAL CLINICS INC
Active
Other names
Pontotoc Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD KIMBROUGH (CBO MANAGER)
(662) 489-7430
Entity
Organization
Contact information
Practice address
345 HIGHWAY 15 N, PONTOTOC, MS 38863-1105
(662) 489-7430
(662) 489-7938
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
—
09014019
—
MS
Enumeration date
06/28/2006
Last updated
08/22/2020
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