| NPI | 1144274622 |
|---|---|
| Doing Business As | GLOSTER CLINIC |
| Doing Business As | FMCH GLOSTER CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEREMY CHAD NETTERVILLE Administrator 601-890-0545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2019-09-12 |