Organization
PACE MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL PACE M.D. (MANAGER)
(601) 788-6381
Entity
Organization
Contact information
Practice address
406 SOUTH FRONT STREET, RICHTON, MS 39476
(601) 788-6381
(601) 788-9716
Mailing address
PO BOX 850, RICHTON, MS 39476-0850
(601) 788-6381
(601) 788-9716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15454
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01629346
—
MS
Enumeration date
02/12/2007
Last updated
08/22/2020
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