| Organization Name: | CORNER CLINIC URGENT CARE LLC |
| NPI Number: | 1073971792 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE H HOUSTON (MEMBER) |
| Mailing Address: | 132 Lakeland Heights Blvd Ste A Flowood |
| State: | MS US |
| Postal Code: | 392326684 |
| Phone Number: | 6019920004 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2016 |
| NPI Last Update Date: | 06/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | R867447 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |