Leake Memorial Medical Clinic Walnut Grove

LBN: Leake Memorial Medical Clinic Walnut Grove
Leake Memorial Medical Clinic Walnut Grove is an health care organization with primary practice located at 110 Park St , Walnut Grove MS 39189-6526. The organization recently has only one registered license in Hospitals / Rural, which is considered as the primary health care specialty. Leake Memorial Medical Clinic Walnut Grove can be contacted via phone (601) 267-1400, or through Estep, Kristi via phone (601) 267-1400.

Contact Information

Primary practice address
110 Park St Walnut Grove MS 39189-6526
Phone: (601) 267-1400
Fax: (601) 253-9464
Website:
Map and Directions
Authorized official contact:
Name: Estep, Kristi
Phone: (601) 267-1400

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Rural 282NR1301X

Profile Details

NPI number 1053576819
LBN Legal business name Leake Memorial Medical Clinic Walnut Grove
DBA Doing business as
Authorized official Estep, Kristi
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2008
Last updated Jul 22nd, 2008 - about 18 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 1053576819 NPPES
Mississippi MEDICAID 05874018

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