# THAXTON FAMILY MEDICAL CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124505912
- **Authorized official:** MR. KEVIN FLOYD NP-C (PROVIDER/MANAGING MEMBER)
- **Authorized official phone:** (662) 213-7890

## Contact information

- **Practice address:** 11145 HIGHWAY 6 W, THAXTON, MS 38871-9024
- **Practice address phone:** (662) 489-8500
- **Practice address fax:** (662) 489-8600
- **Mailing address:** 11145 HIGHWAY 6 W, THAXTON, MS 38871-9024
- **Mailing address phone:** (662) 489-8500
- **Mailing address fax:** (662) 489-8600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 901818 | MS | — |
| 363LP2300X | Primary Care Nurse Practitioner | 901818 | MS | Yes |

## Other

- **Enumeration date:** 07/24/2018
- **Last updated:** 07/24/2018