Magnolia Internal Medical Clinic

LBN: Magnolia Internal Medical Clinic
Magnolia Internal Medical Clinic is an health care organization with primary practice located at 5 River Bend Pl Suite C, Flowood MS 39232-7618. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Magnolia Internal Medical Clinic can be contacted via phone (601) 933-9696, or through Summers, Evan L. via phone (601) 933-9696.

Contact Information

Primary practice address
5 River Bend Pl Suite C Flowood MS 39232-7618
Phone: (601) 933-9696
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Summers, Evan L. Doctor of Medicine (MD)
Phone: (601) 933-9696

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 16638 Mississippi

Profile Details

NPI number 1467567990
LBN Legal business name Magnolia Internal Medical Clinic
DBA Doing business as
Authorized official Summers, Evan L. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 21st, 2006
Last updated Jul 13th, 2007 - 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 1467567990 NPPES
Mississippi MEDICAID 06923312

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