# CHRIST UNITED MEDICAL CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Christ United Medical Clinic, Christ United Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689231367
- **Authorized official:** ALYSSA CAMERON WHITEHEAD FNP-C (FNP-C, CLINIC ADMINISTRATOR)
- **Authorized official phone:** (662) 446-9012

## Contact information

- **Practice address:** 2750 N CHURCH AVE, LOUISVILLE, MS 39339-2054
- **Practice address phone:** (662) 446-9012
- **Practice address fax:** (662) 446-9432
- **Mailing address:** 9573 HIGHWAY 490, LOUISVILLE, MS 39339-9192
- **Mailing address phone:** (662) 446-9012

## Taxonomy

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

## Other

- **Enumeration date:** 05/28/2019
- **Last updated:** 02/11/2021