Magnolia Family Medicine, Pllc

LBN: Magnolia Family Medicine, Pllc
Magnolia Family Medicine, Pllc is an health care organization with primary practice located at 415 Marion Ave Suite 399, Mccomb MS 39648-2709. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Magnolia Family Medicine, Pllc can be contacted via phone (601) 684-8800, or through Montgomery, Larry Lee via phone (601) 684-8800.

Contact Information

Primary practice address
415 Marion Ave Suite 399 Mccomb MS 39648-2709
Phone: (601) 684-8800
Fax: (601) 914-2937
Website:
Map and Directions
Authorized official contact:
Name: Montgomery, Larry Lee Doctor of Medicine (MD)
Phone: (601) 684-8800

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16277 Mississippi

Profile Details

NPI number 1699787515
LBN Legal business name Magnolia Family Medicine, Pllc
DBA Doing business as
Authorized official Montgomery, Larry Lee Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 12th, 2006
Last updated Mar 7th, 2023 - about 2 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 1699787515 NPPES
Mississippi MEDICAID 00120513
Mississippi Other 16277

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