Organization
PUCKETT MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA DEVELIN CFNP (OWNER)
(601) 824-9490
Entity
Organization
Contact information
Practice address
6455 HIGHWAY 18, BRANDON, MS 39042-7536
(601) 824-9490
(601) 824-9533
Mailing address
PO BOX 366, PUCKETT, MS 39151-0366
(601) 824-9490
(691) 824-9533
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
R633283
MS
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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