Durant Primary Care Clinic
Clinic/Center, Primary Care in Durant, MS. Organization (NPI-2).
NPI number1124100813
StatusActive
Last updated in NPPESSep 29, 2009
Details
- NPI
- 1124100813
- Entity type
- Organization (NPI-2)
- Legal business name
- Durant Primary Care Clinic
- Organization subpart
- No
- Enumeration date
- Oct 20, 2006
- Last updated
- Sep 29, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
638 Northwest AveDurant, MS 39063-3337
Phone 662-653-1002 · Fax 662-653-1038
Mailing address
638 Northwest AveDurant, MS 39063-3337
Phone 662-653-1002 · Fax 662-653-1038
Authorized official
Elias Abboud
Owner
6626531002
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