Organization
HERNANDO FAMILY MEDICAL CLINIC, LLC
Active
Other names
SLUDER MEDICAL CLINIC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WYNN (BILLING MANAGER)
(662) 429-4988
Entity
Organization
Contact information
Practice address
2778 HIGHWAY 51 S, SENATOBIA, MS 38668-9403
(662) 429-4988
(662) 429-4966
Mailing address
2778 HIGHWAY 51 S, SENATOBIA, MS 38668-9403
(662) 429-4988
(662) 429-4966
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000735805
—
MS
Enumeration date
11/08/2006
Last updated
04/03/2024
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