Rolling Fork Medical Clinic, LLC
Rolling Fork Medical Clinic, LLC is a healthcare organization registered as Family Medicine Physician in Rolling Fork, MS, holding Type 2 (organization) NPI 1275174971 since 2019. The authorized official on file is Lisa Hearn, Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1275174971 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Rolling Fork Medical Clinic, LLC |
| Practice address | 44 S FOURTH ST, Rolling Fork, MS, 39159 |
| Phone | 6623354105 |
| Fax | 6623782879 |
| Enumeration date | 2019-10-03 |
| Last updated in NPPES | 2019-10-03 |
Authorized official
| Name | Lisa Hearn |
|---|---|
| Title | Manager |
| Phone | 6623354105 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05457590 | Medicaid | MS | — |
Copy-ready billing details
Provider: Rolling Fork Medical Clinic, LLC NPI: 1275174971 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 44 S FOURTH ST, Rolling Fork, MS, 39159
Verify this record
Cross-check NPI 1275174971 against the authoritative CMS record: view Rolling Fork Medical Clinic, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Where is Rolling Fork Medical Clinic, LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-10-03.