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General NPI Number Information
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NPI Number | 1114864238
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Entity Type | Organization
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Legal Business Name | THE CLINIC, LLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 2119 HIGHWAY 82 E
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City | GREENVILLE
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State | MS
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Zip | 38703-6010
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Country | US
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Telephone | 662-522-8290
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Fax | 662-522-8294
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Provider Business Mailing Address
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Address Line | 2119 HIGHWAY 82 E
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City | GREENVILLE
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State | MS
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Zip | 38703-6010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BLAIR MARBLE
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Credential |
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Telephone | 601-613-5021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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