SOUTHSIDE MEDICAL CLINIC, LLC – NPI #1386470367
Clinic/Center

SOUTHSIDE MEDICAL CLINIC, LLC is an AHC clinic located in GRENADA, MS. NPPES has assigned the NPI number 1386470367 to SOUTHSIDE MEDICAL CLINIC, LLC on September 09, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHSIDE MEDICAL CLINIC, LLC below.

NPI Profile for
SOUTHSIDE MEDICAL CLINIC, LLC

NPI Number
1386470367
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHSIDE MEDICAL CLINIC, LLC
Primary location
3800 COMMERCE ST
GRENADA, MS 38901
Phone: (662) 230-1161 Fax:
Mailing address
86 BAKERS GATE
GRENADA, MS 38901-9775
Phone: (662) 230-1161 Fax:
Organization Subpart
No
Authorized Official
LEIGH CAIN
CREDENTIALING
Phone: (662) 809-7559
Updated
Certification Date
Sep 03, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.