Mission Primary Care Clinic Pllc
NPI #1487852018 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1487852018
- Entity Type
- Organization
- Organization Name
- Mission Primary Care Clinic Pllc
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jul 5, 2007
- Last Updated
- May 25, 2022
Practice Location
- Address
- 1901 MISSION 66
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-3711
- Phone
- (601) 636-0097
Authorized Official
- Name
- BILL FULCHER
- Title
- ADM
- Phone
- (601) 636-0097
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
| Family Medicine |
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