Westside Family Medical Clinic Pllc

LBN: Westside Family Medical Clinic Pllc
Westside Family Medical Clinic Pllc is an health care organization with primary practice located at 2372 Ms Highway 49 East , Sumner MS 38957. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Westside Family Medical Clinic Pllc can be contacted via phone (662) 375-9310, or through Tucker, Robert Larry via phone (662) 375-9810.

Contact Information

Primary practice address
2372 Ms Highway 49 East Sumner MS 38957
Phone: (662) 375-9310
Fax: (662) 375-9311
Website:
Map and Directions
Authorized official contact:
Name: Tucker, Robert Larry Nurse Practitioner (NP)
Phone: (662) 375-9810

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X R853452 Mississippi

Profile Details

NPI number 1811234636
LBN Legal business name Westside Family Medical Clinic Pllc
DBA Doing business as
Authorized official Tucker, Robert Larry Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 14th, 2013
Last updated Apr 2nd, 2013 - about 13 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 1811234636 NPPES
Mississippi MEDICAID 0123085

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