Organization
REGIONAL MEDICAL CLINIC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY DUDLEY EVANS M.D. (OWNER/PHYSICIAN)
(601) 943-5060
Entity
Organization
Contact information
Practice address
4297 HIGHWAY 42, BASSFIELD, MS 39421-4424
(601) 943-5060
(601) 943-5888
Mailing address
PO BOX 68, BASSFIELD, MS 39421-0068
(601) 943-5060
(601) 943-5888
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
13317
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111136
—
MS
01
—
1952465619
PHYSICIAN NPI
—
Enumeration date
11/12/2009
Last updated
11/03/2015
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