YALOBUSHA MEDICAL CLINIC LLC NPI 1295090009

NPI Information

  • NPI: 1295090009
  • Provider Name: YALOBUSHA MEDICAL CLINIC, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 712 S MAIN ST
    WATER VALLEY, MS
    ZIP 38965
  • Phone: (662) 473-1140

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NPI Details

YALOBUSHA MEDICAL CLINIC, LLC is a primary care clinic center in Water Valley, MS. YALOBUSHA MEDICAL CLINIC, LLC NPI is 1295090009. The provider is registered as an organization entity type.

The provider's business location address is:

712 S MAIN ST
WATER VALLEY, MS
ZIP 38965-334
Phone: (662) 473-1140
Fax: (662) 473-1138

The provider's authorized official is Cinnamon Foster .
The authorized official title is Sole Member and has the following contact phone number (662) 473-1140.

The enumeration date for this NPI number is 7/8/2012 and was last updated on 4/5/2022.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareR872547MISSISSIPPIYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11659607232OTHERNPI, TYPE 1

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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