Canton Family Clinic Inc. | |
120 E Academy St Canton MS 39046-4502 | |
(601) 859-2611 | |
Not Available |
Full Name | Canton Family Clinic Inc. |
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Speciality | Clinic/center - Primary Care |
Location | 120 E Academy St, Canton, Mississippi |
Authorized Official Name and Position | Jerry Lousteau (CLINIC ADMINISTRATOR) |
Authorized Official Contact | 6018592611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Canton Family Clinic Inc. 120 E Academy St Canton MS 39046-4502 Ph: () - | Canton Family Clinic Inc. 120 E Academy St Canton MS 39046-4502 Ph: (601) 859-2611 |
NPI Number | 1902088453 |
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Provider Enumeration Date | 11/27/2007 |
Last Update Date | 03/03/2010 |
Identifier | Type | State | Issuer |
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1902088453 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 09015552 (Mississippi) | Primary |
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