Healthcare Provider Details

I. General information

NPI: 1902826951
Provider Name (Legal Business Name): SENTER MEDICAL CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 THIRD STREET
BELMONT MS
38827
US

IV. Provider business mailing address

PO BOX 549
BELMONT MS
38827-0549
US

V. Phone/Fax

Practice location:
  • Phone: 662-454-7170
  • Fax: 662-454-7177
Mailing address:
  • Phone: 662-454-7170
  • Fax: 662-454-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10171
License Number StateMS

VIII. Authorized Official

Name: DR. STEPHEN K SENTER
Title or Position: OWNER
Credential: M.D
Phone: 662-454-7170