# GREENVILLE FAMILY CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GREENVILLE FAMILY CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598946667
- **Authorized official:** PAM G MADDOX (OFFICE MANAGER)
- **Authorized official phone:** (662) 378-0283

## Contact information

- **Practice address:** 867 MISSISSIPPI ST, GREENVILLE, MS 38701-5963
- **Practice address phone:** (662) 378-0283
- **Practice address fax:** (662) 332-3316
- **Mailing address:** 867 MISSISSIPPI ST, GREENVILLE, MS 38701-5963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11843 | MS | Yes |

## Other

- **Enumeration date:** 11/16/2007
- **Last updated:** 01/26/2012