| Organization Name: | DURANT PRIMARY CARE CLINIC |
| NPI Number: | 1124100813 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIAS ABBOUD (OWNER) |
| Mailing Address: | 638 Northwest Ave Durant |
| State: | MS US |
| Postal Code: | 390633337 |
| Phone Number: | 6626531002 |
| Fax Number: | 6626531038 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 09/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |