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Walthal Rural Health Clinic

Internal Medicine in Tylertown, MS. Organization (NPI-2).

NPI number1144530403
StatusActive
Last updated in NPPESApr 11, 2013

Details

NPI
1144530403
Entity type
Organization (NPI-2)
Legal business name
Walthal Rural Health Clinic
Organization subpart
No
Enumeration date
Oct 20, 2010
Last updated
Apr 11, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine10220MSYes

Other names

  • Tylertown Internal Medicine Clinic (Doing Business As)

Practice location

200 Hospital Dr
Tylertown, MS 39667-2020

Phone 601-876-5303

Mailing address

Po Box 677
Tylertown, MS 39667-0677

Authorized official

Evan Dillard
President/Ceo
6012884490

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