Provider Demographics
NPI:1497384895
Name:ALLIANCE URGENT CARE CLINIC
Entity Type:Organization
Organization Name:ALLIANCE URGENT CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-252-1599
Mailing Address - Street 1:PO BOX 5083
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38634-5083
Mailing Address - Country:US
Mailing Address - Phone:662-252-1599
Mailing Address - Fax:662-252-6790
Practice Address - Street 1:1938 CRESCENT MEADOWS DR STE C
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-7419
Practice Address - Country:US
Practice Address - Phone:662-252-1599
Practice Address - Fax:662-252-1986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care