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Organization
MAGNOLIA FAMILY MEDICAL CLINIC
Active
Organization
MAGNOLIA FAMILY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B KAYOMA MD (OWNER)
(662) 332-2077
Entity
Organization
Contact information
Practice address
1660 S COLORADO ST, GREENVILLE, MS 38703-7216
(662) 332-2077
(662) 332-0790
Mailing address
1660 S COLORADO ST, GREENVILLE, MS 38703-7216
(662) 332-2077
(662) 332-0790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17503
MS
Other
Enumeration date
05/23/2007
Last updated
12/31/2007
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