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Organization
BAZ FAMILY MEDICAL CLINIC
Active
Organization
BAZ FAMILY MEDICAL CLINIC
Active
Other names
Baz Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE SHABAZZ NP (PRESIDEN)
(717) 421-5490
Entity
Organization
Contact information
Practice address
4310 CHICOT ST, PASCAGOULA, MS 39581-4700
(717) 421-5490
Mailing address
7922 LONGWOOD DR, GAUTIER, MS 39553-2629
(717) 421-5490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R885984
MS
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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