| Organization Name: | VML MEDICAL SERVICES OF BOONEVILLE INC |
| NPI Number: | 1215247937 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICKI MICHELLE LAMBERT (OWNER) |
| Mailing Address: | 121 South Second Street Baldwyn |
| State: | MS US |
| Postal Code: | 38824 |
| Phone Number: | 6623652725 |
| Fax Number: | 6623652737 |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 09/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | R574996 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |