<Unavail>
LBN: Clinton Wellness Center Llc
<Unavail> is an health care organization with primary practice located at 514 E Woodrow Wilson Ave Suite C, Jackson MS 39216-4538. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Clinton Wellness Center Llc can be contacted via phone (601) 714-8180, or through Dudley, Shinita Reed via phone (601) 714-8180.
Contact Information
Primary practice address
514 E Woodrow Wilson Ave Suite C
Jackson MS 39216-4538
Phone: (601) 714-8180
Fax: (601) 922-9900
Website:
Authorized official contact:
Name: Dudley, Shinita Reed Doctor of Medicine (MD)
Phone: (601) 714-8180
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 18239 | Mississippi |
Profile Details
| NPI number | 1710231576 |
|---|---|
| LBN Legal business name | Clinton Wellness Center Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Dudley, Shinita Reed Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2012 |
| Last updated | Nov 1st, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710231576 | NPPES |
| Mississippi | MEDICAID | 07033864 | |
| Mississippi | Other | 512I080023 | |
| Mississippi | Other | 1413306 | |
| Mississippi | Other | 587159423I |
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