The Clinic at Elm Lake, P.a.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

MS13926 Issued in MS

Legal business name

THE CLINIC AT ELM LAKE, P.A.

Practice address

3700 N Frontage Rd
Columbus, MS 39701

Phone

(662) 240-9999

Fax

(662) 241-5451

NPI assigned

Aug 1, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Annmarie Stokes, M.D.

Title

Medical Director

Phone

(662) 240-9999

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1215193933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N FRONTAGE RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-240-9999",
            "fax_number": "662-241-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N FRONTAGE RD",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-240-9999",
            "fax_number": "662-241-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC AT ELM LAKE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "662-240-9999",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "MS",
            "license": "MS13926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.