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Organization
FMC MEDICAL FOUNDATION, INC
Active
Organization
FMC MEDICAL FOUNDATION, INC
Active
Other names
FMC Canyon, Family Medicine Center Canyon
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIE FEEMSTER (CREDENTIALING SPECIALIST)
(806) 358-9400
Entity
Organization
Contact information
Practice address
911 23RD STREET, CANYON, TX 79015-4600
(806) 655-2104
(806) 655-0522
Mailing address
911 23RD STREET, CANYON, TX 79015-4600
(806) 655-2104
(806) 655-0522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/12/2006
Last updated
03/03/2020
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