| Organization Name: | HORN LAKE FAMILY PRACTICE INC |
| NPI Number: | 1508968421 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHEETAL SHARMA (OFFICE MANAGER) |
| Mailing Address: | 3102 Goodman Rd W Horn Lake |
| State: | MS US |
| Postal Code: | 386371172 |
| Phone Number: | 6623426677 |
| Fax Number: | 6623421213 |
| NPI Enumeration Date: | 09/01/2006 |
| NPI Last Update Date: | 07/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | 15476 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |