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Mississippi Medical Clinic, LLC

Company Details

Name: Mississippi Medical Clinic, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 12 Jul 2021 (4 years ago)
Business ID: 1293485
ZIP code: 39168
County: Smith
State of Incorporation: MISSISSIPPI
Principal Office Address: 403 PINE STTAYLORSVILLE, MS 39168

Agent

Name Role Address
Daniel Ferguson Agent 1284 Main Street South, Mendenhall, MS 39114

Member

Name Role Address
Daniel Ferguson Member 1284 Main Street South, Mendenhall, MS 39114
Brent A Bullock Member 11 Hidden Hollow Drive, Laurel, MS 39443
Patricia Bullock Member 11 Hidden Hollow Drive, Laurel, MS 39443
Chante N Ferguson Member 1284 Main Street South, Mendenhall, MS 39114

U.S. Small Business Administration Profile

The U.S. Small Business Administration (SBA) helps Americans start, grow, and build resilient businesses.

Note: SBA was created in 1953 as an independent agency of the federal government to aid, counsel, assist and protect the interests of small business concerns; preserve free competitive enterprise; and maintain and strengthen the overall economy of our nation. SBA reviews Congressional and testifies on behalf of small businesses. It assesses the impact of regulatory burden on small businesses.

Phone Number:
E-mail Address:
Contact Person:
PATRICIA BULLOCK
User ID:
P3246753

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
FPXPRD994HG5
CAGE Code:
9UAN8
UEI Expiration Date:
2026-01-28

Business Information

Division Name:
MISSISSIPPI MEDICAL CLINIC LLC
Activation Date:
2025-01-30
Initial Registration Date:
2024-02-27

National Provider Identifier

NPI Number:
1114694536
Certification Date:
2022-04-11

Authorized Person:

Name:
MRS. PATTY BULLOCK
Role:
NP MANAGING PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
6014527083

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-01-26 Annual Report For Mississippi Medical Clinic, LLC
Annual Report LLC Filed 2024-03-06 Annual Report For Mississippi Medical Clinic, LLC
Annual Report LLC Filed 2023-07-21 Annual Report For Mississippi Medical Clinic, LLC
Annual Report LLC Filed 2022-04-12 Annual Report For Mississippi Medical Clinic, LLC
Amendment Form Filed 2022-02-02 Amendment For Mississippi Medical Clinic, LLC
Formation Form Filed 2021-07-12 Formation For Mississippi Medical Clinic, LLC

Date of last update: 27 May 2025

Sources: Company Profile on Mississippi Secretary of State Website