Organization Name: | ABERDEEN HEALTH CLINIC INC |
NPI Number: | 1083767271 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EUNICE CRUMP (OWNER MANAGER) |
Mailing Address: | 501 Chestnut Street Aberdeen |
State: | MS US |
Postal Code: | 39730 |
Phone Number: | 6623696131 |
Fax Number: | 6623694588 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 09/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | R857916 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |