PSP MEDICAL CLINIC NPI 1245502723

NPI Information

PSP MEDICAL CLINIC is a primary care clinic center in Flowood, MS. PSP MEDICAL CLINIC NPI is 1245502723. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Magnolia Medical Clinics.

The provider's business location address is:

2629 COURTHOUSE CIR
FLOWOOD, MS
ZIP 39232-521
Phone: (601) 420-4300
Fax: (601) 420-4310

The provider's authorized official is Parvesh K. Goel .
The authorized official title is Md and has the following contact phone number (601) 859-9888.

The CLIA number assigned to this NPI record is 25D1052898 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2012 and was last updated on 4/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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