Mississippi Medical Clinic
NPI #1114694536 in Taylorsville, Mississippi
Provider Information
- NPI Number
- 1114694536
- Entity Type
- Organization
- Organization Name
- Mississippi Medical Clinic
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Aug 24, 2021
- Last Updated
- Apr 25, 2022
Practice Location
- Address
- 403 PINE ST
- City
- Taylorsville
- State
- Mississippi
- ZIP Code
- 39168-5659
- Phone
- (601) 452-7080
Authorized Official
- Name
- MRS. PATTY BULLOCK, NP
- Title
- NP MANAGING PARTNER
- Phone
- (601) 452-7080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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