| Organization Name: | MAGNOLIA URGENT CARE INC |
| NPI Number: | 1033475165 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLIFFORD EUGENE BAKER (NURSE PRACTITIONER) |
| Mailing Address: | 2201 Highway 49 Ste B Wiggins |
| State: | MS US |
| Postal Code: | 395778012 |
| Phone Number: | 6019282798 |
| Fax Number: | 6019282790 |
| NPI Enumeration Date: | 04/03/2012 |
| NPI Last Update Date: | 04/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |