NPI | 1255498176 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES L. COLEMAN CEO 601-859-5213 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 122300000X Dentist |
207Q00000X Family Medicine | |
208000000X Pediatrics | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2007-01-02 |
Last Update Date | 2018-06-25 |