# MOWA BAND OF CHOCTAW INDIANS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOWA CHOCTAW TRIBAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336907948
- **Authorized official:** LEBARON BYRD (CHIEF)
- **Authorized official phone:** (251) 786-0829

## Contact information

- **Practice address:** 1080 RED FOX RD W, MOUNT VERNON, AL 36560-2629
- **Practice address phone:** (251) 829-9023
- **Practice address fax:** (855) 933-1195
- **Mailing address:** 1080 RED FOX RD W, MOUNT VERNON, AL 36560-2629
- **Mailing address phone:** (251) 786-0829
- **Mailing address fax:** (855) 933-1195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2024
- **Last updated:** 04/17/2024