| NPI | 1568797223 |
|---|---|
| Doing Business As | SOUTH MAIN FAMILY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARSHA T HOUK Nurse Practitioner 662-256-3858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS R797975) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2010-11-10 |