Main Street Medical, LLC

NPI #1013340892 in Louisville, Mississippi

Provider Information

NPI Number: 1013340892
Entity Type: Organization
Organization Name: Main Street Medical, LLC
Primary Specialty: Family Medicine
Enumeration Date: Aug 15, 2013
Last Updated: Aug 16, 2013

Practice Location

Address: 106 W MAIN ST
City: Louisville
State: Mississippi
ZIP Code: 39339-2620
Phone: (662) 803-5318

Authorized Official

Name: EMILY DAVIS PERKINS
Title: FAMILY NURSE PRACTITIONER
Phone: (662) 803-5318

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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