| Montgomery Family Clinic | |
|
122 Weisenberger Rd Madison MS 39110-7993 | |
| (601) 790-9098 | |
| (601) 790-9098 |
| Full Name | Montgomery Family Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 122 Weisenberger Rd, Madison, Mississippi |
| Authorized Official Name and Position | Susan L Montgomery (OWNER/PROVIDER) |
| Authorized Official Contact | 6017909098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montgomery Family Clinic 122 Weisenberger Rd Madison MS 39110-7993 Ph: (601) 790-9098 | Montgomery Family Clinic 122 Weisenberger Rd Madison MS 39110-7993 Ph: (601) 790-9098 |
| NPI Number | 1235429648 |
|---|---|
| Provider Enumeration Date | 04/19/2011 |
| Last Update Date | 04/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235429648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R524174 (Mississippi) | Primary |
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