PUCKETT MEDICAL CLINIC (NPI# 1932476280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932476280 |
| Entity Type | Organization |
| Organization Name | PUCKETT MEDICAL CLINIC |
| Practice Address |
6455 Highway 18 Brandon MS 39042-7536 |
| Mailing Address |
Po Box 366 Puckett MS 39151-0366 |
| Practice Telephone | 6018249490 |
| Practice Fax Number | 6018249533 |
| Mailing Telephone | 6018249490 |
| Mailing Fax Number | 6918249533 |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | DEBRA DEVELIN (OWNER) |
| Authorized Official Telephone | 6018249490 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
R633283 | MS | Ambulatory Health Care Facilities |
| Street Address |
6455 HIGHWAY 18 |
| City | BRANDON |
| State | MS |
| Zip Code | 39042-7536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285249 | Puckett Family Medical Clinic | Nurse Practitioner | 6455 Highway 18, Brandon, MS 39042-7536 | 2020-08-16 |
| 1841450483 | Simpson Community Healthcare, Inc | Clinic/Center | 6455 Highway 18, Brandon, MS 39042 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821529 | Claudia Francis Jones | Technician | 1008 Greenfield Circle, Brandon, MS 39042 | 2019-10-03 |
| 1194294546 | Allen Keith Johnson Jr. | Counselor | 1700 West Government Street Building B. Suite O., Brandon, MS 39042 | 2018-11-15 |
| 1689167462 | Regional Home Care and Infusions, Inc. | Registered Nurse | 302 Town Square, Suite 110, Brandon, MS 39042 | 2018-06-07 |
| 1013419563 | Brandon Family Chiropractic LLC | Chiropractor | 1350 West Government Street Suite A1, Brandon, MS 39042 | 2018-03-01 |
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1104275510 | Matthew Logue | Community Health Worker | 2009 Mossy Cove, Brandon, MS 39042 | 2016-06-07 |
| 1932569704 | Haley Wilson | Chiropractor | 1350 W Government St Ste A1, Brandon, MS 39042 | 2016-03-07 |
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1760825434 | Linda J. Bridges | Respiratory Therapist, Certified | 330 Rankin Road, Brandon, UNITED STATES 39042 | 2013-04-12 |
| 1861739922 | Georgia Christine Shirley | Nurse Practitioner | 2008 Brookstone Place, Brandon, MS 39042 | 2013-01-09 |
| Find all providers in zip 39042 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1245576685 | Pharmclinic Two LLC | Clinic/Center | 1135 Professional Park Dr, Brandon, FL 33511-4887 | 2012-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303010 | Northwest Health and Wellness, Inc | Clinic/Center | 215 Northwest Drive, Senatobia, MS 38668 | 2020-10-12 |
| 1538786090 | Essential Health & Wellness Clinic P.a. | Clinic/Center | 5842 Goodman Rd Ste 1, Horn Lake, MS 38637-8106 | 2020-07-01 |
| 1144841826 | Love and Care Adult Daycare and Personal Care Services | Clinic/Center | 521 Brentwood Ave, Greenwood, MS 38930-6910 | 2020-05-04 |
| 1982254389 | Lca of Ms, LLC | Clinic/Center | 6098 U S Highway 98 Ste 4, Hattiesburg, MS 39402-8878 | 2019-09-17 |
| 1841849791 | Ayanna Hawkins | Clinic/Center | 1294 White Oak Rd, Tunica, MS 38676-9743 | 2019-09-04 |
| 1003463928 | Np Professional Services, LLC | Clinic/Center | 17 Church Cv, Beulah, MS 38726-9430 | 2019-08-26 |
| 1760035232 | Mcmedical Country Clinic LLC | Clinic/Center | 52 County Road 74, Mc Carley, MS 38943-6820 | 2019-07-23 |
| 1720550775 | Karen Jackson | Clinic/Center | 104 Taggart Dr, Steens, MS 39766-9563 | 2018-12-31 |
| 1831672435 | Healthcareonthego, LLC | Clinic/Center | 3901 King Rd, Meridian, MS 39305-2533 | 2018-09-10 |
| 1568949097 | Lifespan Wellness LLC | Clinic/Center | 101 Rouselle Pl Ste A, Ocean Springs, MS 39564-3074 | 2018-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.