Active NPI
Trace Medical Clinic, PLLC
- Family Medicine Physician
- Kosciusko, MS
National Provider Identifier
1376846469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- TRACE MEDICAL CLINIC, PLLC
- Practice address
- 530 Veterans Memorial Dr
Kosciusko, MS 39090-3858 - Phone
- (662) 289-9155
- Fax
- (662) 289-7752
- NPI assigned
- Dec 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert G Browning, MD
- Title
- President
- Phone
- (662) 289-9155
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
530 Veterans Memorial Dr
Kosciusko, MS 39090-3858
Mailing address
530 Veterans Memorial Dr
Kosciusko, MS 39090-3858
Phone (662) 289-9155
National Provider Directory
National Provider DirectoryLocations
530 Veterans Memorial Dr
Kosciusko, MS 39090
Phone (662) 289-9155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291939200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1291939200000",
"number": "1376846469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 VETERANS MEMORIAL DR",
"city": "KOSCIUSKO",
"state": "MS",
"postal_code": "390903858",
"telephone_number": "662-289-9155",
"fax_number": "662-289-7752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 VETERANS MEMORIAL DR",
"city": "KOSCIUSKO",
"state": "MS",
"postal_code": "390903858",
"telephone_number": "662-289-9155",
"fax_number": "662-289-7752"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRACE MEDICAL CLINIC, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-12-10",
"last_updated": "2010-12-10",
"status": "A",
"authorized_official_last_name": "BROWNING",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "662-289-9155",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kosciusko, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.