| NPI | 1316557986 |
|---|---|
| Doing Business As | 149 PEDIATRIC AND FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOHN P LEE Chairman Of The Board 601-469-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2022-10-06 |