| NPI | 1649337577 |
|---|---|
| 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 |