Southside Medical Clinic, LLC
Organization Active NPI Primary Care Clinic/Center · Grenada, MS
NPI 1386470367 · NPPES record last updated Sep 9, 2024
Key facts
- NPI
- 1386470367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- SOUTHSIDE MEDICAL CLINIC, LLC
- Practice address
- 3800 Commerce St
Grenada, MS 38901 - Phone
- (662) 230-1161
- NPI assigned
- Sep 9, 2024
- Organization subpart
- No
Authorized official
- Name
- Leigh Cain
- Title
- Credentialing
- Phone
- (662) 809-7559
Practitioners 1
-
Amber Brooke Hankins, FNP-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
3800 Commerce St
Grenada, MS 38901
Mailing address
86 Bakers Gate
Grenada, MS 38901-9775
Phone (662) 230-1161
Other names
- Southside Medical Clinic
Other providers in Grenada, MS
- Kaleb Smith
- Olivia Carpenter Smith
- Darley Jelgin Solomon Jr.
- Dion T Sones
- Southern Hospitality Adult Daycare, LLC
- Tonesha Spearman
- Speech Pathology Services
- Stanford Medical Inc
- James K Stanford
- State of Mississippi - University of Mississippi Medical Center
All providers in Grenada, MS · Primary Care Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.