Organization
CROSSROADS HEALTH CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORA MCFALLS CFNP (PRESIDENT)
(662) 286-2300
Entity
Organization
Contact information
Practice address
1801 S HARPER RD STE 7, CORINTH, MS 38834-6726
(662) 286-2300
(662) 286-7010
Mailing address
1801 S HARPER RD STE 7, CORINTH, MS 38834-6726
(662) 286-2300
(662) 286-7010
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
258980
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00656871
—
MS
05
—
0121943
—
MS
01
—
R582662
NURSE LICENSE #
MS
Enumeration date
07/04/2006
Last updated
05/10/2012
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