Organization
LEXINGTON PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULINE HATHCOCK FNP (NURSE PRACTITIONER)
(662) 834-1855
Entity
Organization
Contact information
Practice address
110 TCHULA STREET, LEXINGTON PRIMARY CARE, LEXINGTON, MS 39095
(662) 834-1855
(662) 834-4953
Mailing address
PO BOX 249, LEXINGTON, MS 39095-0249
(662) 834-1855
(662) 834-4953
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
R851692
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115646
—
MS
Enumeration date
08/18/2006
Last updated
08/12/2008
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