Mission Primary Care Clinic Pllc
LBN: Mission Primary Care Clinic Pllc
Mission Primary Care Clinic Pllc is an health care organization with primary practice located at 1901 Mission 66 , Vicksburg MS 39180-3711. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Mission Primary Care Clinic Pllc can be contacted via phone (601) 636-0097, or through Fulcher, Bill via phone (601) 636-0097.
Contact Information
Primary practice address
1901 Mission 66
Vicksburg MS 39180-3711
Phone: (601) 636-0097
Fax: (601) 629-9969
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R829001 | Mississippi |
Profile Details
| NPI number | 1487852018 |
|---|---|
| LBN Legal business name | Mission Primary Care Clinic Pllc |
| DBA Doing business as | |
| Authorized official | Fulcher, Bill |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 5th, 2007 |
| Last updated | May 25th, 2022 - about 4 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 | 1487852018 | NPPES |
| Mississippi | MEDICAID | 04935090 |
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