Grayson Creek Medical Clinic, Llc
LBN: Grayson Creek Medical Clinic, Llc
Grayson Creek Medical Clinic, Llc is an health care organization with primary practice located at 3 John Everett Rd , Moselle MS 39459-9771. The organization recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is the primary health care specialty.
Grayson Creek Medical Clinic, Llc can be contacted via phone (601) 620-9991, or through Knight, Mack E via phone (601) 408-9945.
Contact Information
Primary practice address
3 John Everett Rd
Moselle MS 39459-9771
Phone: (601) 620-9991
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 732001 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 901749 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 732001 | Mississippi |
Profile Details
| NPI number | 1184166035 |
|---|---|
| LBN Legal business name | Grayson Creek Medical Clinic, Llc |
| DBA Doing business as | |
| Authorized official | Knight, Mack E FNP-C |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 9th, 2016 |
| Last updated | Oct 19th, 2017 - about 8 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 | 1184166035 | NPPES |
| Mississippi | MEDICAID | 0044232 |
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