Organization
MEDICAL CLINIC LLC
Active
Other names
The Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PACE MD (MANAGING PARTNER)
(864) 915-1949
Entity
Organization
Contact information
Practice address
713 WATTS ST, MONTICELLO, MS 39654-9313
(601) 587-7795
Mailing address
PO BOX 518, MONTICELLO, MS 39654-0518
(864) 915-1949
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780849109
NURSE PRACTITIONER
MS
05
—
1780849109
—
MS
Enumeration date
06/13/2023
Last updated
06/13/2023
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