| Truly Family Healthcare Clinic | |
|
1883 Highway 43 S Ste E Canton MS 39046-8406 | |
| (769) 231-7499 | |
| Not Available |
| Full Name | Truly Family Healthcare Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1883 Highway 43 S Ste E, Canton, Mississippi |
| Authorized Official Name and Position | Natwassie Truly (OWNER/MANAGER) |
| Authorized Official Contact | 7692317499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Truly Family Healthcare Clinic Po Box 743 Canton MS 39046-0743 Ph: (601) 832-5548 | Truly Family Healthcare Clinic 1883 Highway 43 S Ste E Canton MS 39046-8406 Ph: (769) 231-7499 |
| NPI Number | 1932750916 |
|---|---|
| Provider Enumeration Date | 09/22/2019 |
| Last Update Date | 06/28/2020 |
| Medicare PECOS PAC ID | 0648601815 |
|---|---|
| Medicare Enrollment ID | O20200504002544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932750916 | NPI | - | NPPES |
| 08037351 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Natwassie Truly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114427515 PECOS PAC ID: 5395094387 Enrollment ID: I20180824000729 |
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