Childrens Medical Group
Restricted
Childrens Medical Group is subject to Restricted. See the individual lists below.
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Addresses
Address 1 : 559 Arnold AvenueSuite AGreenville, MS 38701
Address 2 : 1421 East Peace Street Canton, MS 39046
ID Details
ID NUMBER : 1629237656
ID TYPE : NPI
ID NUMBER : 1174711279
ID TYPE : NPI
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Childrens Medical Group Sanctioned By Below Authority
| List Name | List Authority | Effective Date ▼ | Status |
|---|---|---|---|
| The Mississippi Division of Medicaid | Nov 26, 2014 | active |
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