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Organization
GREENVILLE FAMILY CLINIC INC
Active
Organization
GREENVILLE FAMILY CLINIC INC
Active
Other names
GREENVILLE FAMILY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
PAM G MADDOX (OFFICE MANAGER)
(662) 378-0283
Entity
Organization
Contact information
Practice address
867 MISSISSIPPI ST, GREENVILLE, MS 38701-5963
(662) 378-0283
(662) 332-3316
Mailing address
867 MISSISSIPPI ST, GREENVILLE, MS 38701-5963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11843
MS
Other
Enumeration date
11/16/2007
Last updated
01/26/2012
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