Organization
INDEPENDENT HEALTHCARE MANAGEMENT, INC.
Active
Other names
Main Street Medical Clinic of Sebastopol
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S MCNULTY III (CEO)
(601) 849-6440
Entity
Organization
Contact information
Practice address
17509 HWY 21, SEBASTOPOL, MS 39359-0000
(601) 625-9818
(601) 625-9904
Mailing address
17509 HWY 21, SEBASTOPOL, MS 39359-0000
(601) 625-9818
(601) 625-9904
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/20/2011
Last updated
12/18/2014
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