Organization
TOCCOPOLA FAMILY MEDICAL CLINIC, LLC
Active
Other names
Toccopola Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE POOLE ROBERTS FNP (OWNER)
(662) 281-8003
Entity
Organization
Contact information
Practice address
7908 HWY 334, TOCCOPOLA, MS 38874-0389
(662) 281-8020
(662) 281-8020
Mailing address
P.O. BOX 389, TOCCOPOLA, MS 38874-0389
(662) 281-8003
(662) 281-8020
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
R549002
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014299
—
MS
Enumeration date
03/08/2007
Last updated
07/21/2022
Update your record
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