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Grenada Lake Medical Center
Family Medicine Physician in Grenada, Mississippi
NPI 1053684548

Grenada Lake Medical Center is a Family Medicine Physician based in Grenada, MS. Grenada Lake Medical Center practices in Grenada, MS. The NPI Number for Grenada Lake Medical Center is 1053684548 and holds a License No. 21836 (Mississippi).

The current practice location address for Grenada Lake Medical Center is 965 Avent Dr Ste 100A, Grenada, MS and can be reached out via phone at 662-227-7444 and via fax at 662-227-7443.

Location: 965 Avent Dr Ste 100A, Grenada, MS, 38901-5045
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1053684548
Provider Name
Grenada Lake Medical Center
Credential
Provider Entity Type
Organization
Address
965 Avent Dr Ste 100A, Grenada, MS, 38901-5045
Phone Number
662-227-7444
Fax Number
662-227-7443
Provider Enumeration Date
02/15/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
11516802 01 MS CAQH
00059747 05 MS
institution
Provider Business Practice Location Address Details
Address
965 Avent Dr Ste 100A
City
Grenada
State
Mississippi
Zip
38901-5045
Phone Number
662-227-7444
Fax Number
662-227-7443
person
Provider Business Mailing Address Details
Address
965 Avent Dr Ste 100A
City
Grenada
State
Mississippi
Zip
38901-5045
Phone Number
662-227-7444
Fax Number
662-227-7443
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
21836 (Mississippi)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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