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General NPI Number Information
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NPI Number | 1952305815
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Entity Type | Organization
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Legal Business Name | HICKORY FLAT CLINIC ASSOCIATION INC
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 OAK ST
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City | HICKORY FLAT
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State | MS
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Zip | 38633-8122
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Country | US
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Telephone | 662-333-6387
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Fax | 662-333-6725
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | HICKORY FLAT
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State | MS
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Zip | 38633-0128
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Country | US
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Telephone | 662-333-6387
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Fax | 662-333-6725
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | SUE MORRISSON
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Credential | CFNP
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Telephone | 662-333-6387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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