| Organization Name: | CHAMPION FAMILY MEDICAL & WELLNESS CENTER- URGENT CARE |
| NPI Number: | 1801174230 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRANDON CHAMPION (ADMINISTRATOR) |
| Mailing Address: | 303b Highway 90 Bay St Louis |
| State: | MS US |
| Postal Code: | 395202832 |
| Phone Number: | 2284674431 |
| Fax Number: | 2284674443 |
| NPI Enumeration Date: | 08/02/2011 |
| NPI Last Update Date: | 08/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |