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General NPI Number Information
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NPI Number | 1760035232
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Entity Type | Organization
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Legal Business Name | MCMEDICAL COUNTRY CLINIC LLC
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 19441 HIGHWAY 82
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City | CARROLLTON
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State | MS
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Zip | 38917-7079
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Country | US
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Telephone | 662-595-4114
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Fax | 662-595-4117
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Provider Business Mailing Address
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Address Line | 19441 HIGHWAY 82
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City | CARROLLTON
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State | MS
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Zip | 38917-7079
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Country | US
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Telephone | 662-595-4114
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Fax | 662-595-4117
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Authorized Official
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Title or Position | VP, REVENUE CYCLE MGMT
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Name | JESSICA PAMPLIN
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Credential |
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Telephone | 601-714-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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