Conlee Clinic Hydration and Spa LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CONLEE CLINIC HYDRATION AND SPA LLC

Practice address

404 Enterprise Dr
Oxford, MS 38655-2946

Phone

(662) 638-3412

NPI assigned

Jan 18, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Hancock

Title

Office Manager

Phone

(662) 507-2769

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1548975154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 901",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386550901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ENTERPRISE DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386552946",
            "telephone_number": "662-638-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONLEE CLINIC HYDRATION AND SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-507-2769"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.