Desoto Family Medical Center - Medicare Primary Care in Southaven, MS

Desoto Family Medical Center is a medicare enrolled primary clinic (Family Medicine) in Southaven, Mississippi. The current practice location for Desoto Family Medical Center is 75 Physician Lane, Southaven, Mississippi. For appointments, you can reach them via phone at (662) 393-7722. The mailing address for Desoto Family Medical Center is 75 Physician Lane, Southaven, Mississippi and phone number is (662) 393-7722.

Desoto Family Medical Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1528150398. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (662) 393-7722.

Contact Information

Desoto Family Medical Center
75 Physician Lane
Southaven
MS 38671
(662) 393-7722
(662) 393-7756

Primary Care Clinic Profile

Full NameDesoto Family Medical Center
SpecialityFamily Medicine
Location75 Physician Lane, Southaven, Mississippi
Authorized Official Name and PositionAngel Burnette (FINANCIAL SERVICES MANAGER)
Authorized Official Contact6622806233
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Desoto Family Medical Center
75 Physician Lane
Southaven
MS 38671

Ph: (662) 393-7722
Desoto Family Medical Center
75 Physician Lane
Southaven
MS 38671

Ph: (662) 393-7722

NPI Details:

NPI Number1528150398
Provider Enumeration Date09/29/2006
Last Update Date10/10/2008

Medicare PECOS Information:

Medicare PECOS PAC ID2567470412
Medicare Enrollment IDO20060404000200

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Medical Identifiers

Medical identifiers for Desoto Family Medical Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528150398NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Desoto Family Medical Center acts as a billing entity for following providers:
Provider NameTroy Dale Morris
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891792883
PECOS PAC ID: 1557379401
Enrollment ID: I20091228000162

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Provider NameAntronette L Mckenzie
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1336146315
PECOS PAC ID: 8022066323
Enrollment ID: I20100125000041

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Provider NameAmy E Bailey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003161373
PECOS PAC ID: 2365664604
Enrollment ID: I20141120002206

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