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General NPI Number Information
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NPI Number | 1699918326
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Entity Type | Organization
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Legal Business Name | SENTER MEDICAL CLINIC, PC
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Dates
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Enumeration Date | 04/10/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 26 3RD STREET
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City | BELMONT
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State | MS
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Zip | 38827-0549
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Country | US
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Telephone | 662-454-7170
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Fax | 662-454-7177
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Provider Business Mailing Address
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Address Line | PO BOX 549
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City | BELMONT
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State | MS
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Zip | 38827-0549
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Country | US
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Telephone | 662-454-7170
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Fax | 662-454-7177
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Authorized Official
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Title or Position | INS COOR
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Name | CINDY D GRUBBS
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Credential |
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Telephone | 662-454-7170
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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 | 11702
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License Number State | AL
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