Avalon Medical Llc

LBN: Avalon Medical Llc
Avalon Medical Llc is an health care organization with primary practice located at 1413 W Quitman St , Iuka MS 38852-1130. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Avalon Medical Llc can be contacted via phone (662) 424-9550, or through Draper, Tommy via phone (662) 424-9550.

Contact Information

Primary practice address
1413 W Quitman St Iuka MS 38852-1130
Phone: (662) 424-9550
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Draper, Tommy
Phone: (662) 424-9550

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1710216346
LBN Legal business name Avalon Medical Llc
DBA Doing business as
Authorized official Draper, Tommy
Entity Organization
Organization subpart 1 No
Enumeration date Dec 10th, 2009
Last updated Oct 18th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710216346 NPPES
Mississippi MEDICAID 04352560

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