Organization
DR SUSAN JENAY NEELY PLLC
Active
Other names
THE CARROLLTON CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN JENAY NEELY DO (PHYSICIAN)
(662) 237-4525
Entity
Organization
Contact information
Practice address
502 GEORGE ST, NORTH CARROLLTON, MS 38947-0220
(662) 237-4525
(662) 237-9781
Mailing address
PO BOX 220, NORTH CARROLLTON, MS 38947-0220
(662) 237-4525
(662) 237-9781
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121561
—
MS
05
—
01588099
—
MS
01
—
426493934A
BLUE CROSS BLUE SHIELD
MS
01
—
P00228400
RAILROAD MEDICARE
MS
Enumeration date
04/19/2007
Last updated
08/04/2008
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