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342 Magnolia Dr Raleigh MS 39153-6012 | |
(601) 200-6809 | |
(601) 200-5929 |
Full Name | |
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Speciality | Family Medicine |
Location | 342 Magnolia Dr, Raleigh, Mississippi |
Authorized Official Name and Position | Danielle Stuart (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 6012004880 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 23666 Jackson MS 39225-3666 Ph: (601) 200-4749 | 342 Magnolia Dr Raleigh MS 39153-6012 Ph: (601) 200-6809 |
NPI Number | 1083032171 |
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Provider Enumeration Date | 04/04/2014 |
Last Update Date | 07/02/2019 |
Identifier | Type | State | Issuer |
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1083032171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 16442 (Mississippi) | Primary |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 Whiteoak Ave, Raleigh, MS 39153 Phone: 601-825-7280 Fax: 601-825-8130 | |