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Organization

PREMIER FOOT CLINIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEFANIE MONIQUE THOMAS DPM (OWNER PRESIDENT)
(601) 926-1500
Entity
Organization

Contact information

Practice address
705 HIGHWAY 80 W, CLINTON, MS 39056-4103
(601) 926-1500
(601) 926-1502
Mailing address
705 HIGHWAY 80 W, CLINTON, MS 39056-4103
(601) 926-1500
(601) 926-1502

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80151
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06981282
MS
Enumeration date
12/27/2006
Last updated
03/12/2008
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