NPI 1003300815

East Main Family Medical Clinic LLC

Organisation Nurse Practitioner Tupelo, MS

Practice location

Address: 1424 E Main St, Tupelo, MS 38804-2956
Phone: (662) 350-3550
Fax: (662) 842-3061
Mailing address: 5024 Raymond Ave, Tupelo, MS 38801-8671

Authorised official

Name: Rodney Brian Rodgers
Title: Owner/Nurse Practitioner
Phone: (662) 350-3550

Registered specialties

Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X Licence R853214 (MS)

Other Nurse Practitioner providers in Mississippi →

Registry record

NPI: 1003300815
Entity type: Organization
NPI issued: 15 Jun 2018
Record last updated: 8 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.