Indianola Clinic, LLC
NPI #1679673917 in Leland, Mississippi
Provider Information
- NPI Number
- 1679673917
- Entity Type
- Organization
- Organization Name
- Indianola Clinic, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- INDIANOLA CLINIC, LLC
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Sep 25, 2006
- Last Updated
- Sep 17, 2024
Practice Location
- Address
- 201 BAKER BLVD
- City
- Leland
- State
- Mississippi
- ZIP Code
- 38756
- Phone
- (662) 686-4121
Authorized Official
- Name
- MRS. AMY MCINTIRE
- Title
- CREDENTIALING
- Phone
- (662) 686-3956
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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