Organization
DR SUSAN JENAY NEELY PLLC
Active
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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