| NPI | 1548370083 |
|---|---|
| Doing Business As | BOONEVILLE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | GERALD KIMBROUGH Manager 662-377-4685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |