Organization
HIGHLAND COMMUNITY CLINIC NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN STEVENS (CFO)
(601) 749-3119
Entity
Organization
Contact information
Practice address
1702 HIGHWAY 11 N, PICAYUNE, MS 39466-2016
(601) 798-4711
Mailing address
801 GOODYEAR BLVD, PICAYUNE, MS 39466-3221
(888) 447-2450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07620530
—
MS
01
—
DP4385
RAILROAD MCARE
MS
Enumeration date
02/09/2009
Last updated
02/09/2010
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