Organization
VAIL FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT IRA VAIL FNP-C (ADMINISTRATOR)
(662) 841-0617
Entity
Organization
Contact information
Practice address
800 E MAIN ST, TUPELO, MS 38804-2826
(662) 841-0617
Mailing address
PO BOX 780, NEW ALBANY, MS 38652-0780
(662) 316-3144
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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