Organization Name: | MIDTOWN FAMILY CLINIC, LLC |
NPI Number: | 1063743706 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PARVEEN KUMAR (OWNER) |
Mailing Address: | 129 S Main St Yazoo City |
State: | MS US |
Postal Code: | 391944007 |
Phone Number: | 6627468777 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2010 |
NPI Last Update Date: | 02/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |