| Organization Name: | CLAIBORNE COUNTY FAMILY HEALTH CENTER, INC. |
| NPI Number: | 1194968982 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONEY L JOHNSON (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 2045 Highway 61 N Port Gibson |
| State: | MS US |
| Postal Code: | 391504262 |
| Phone Number: | 6014373049 |
| Fax Number: | 6014373051 |
| NPI Enumeration Date: | 04/09/2009 |
| NPI Last Update Date: | 04/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |