# BOUNDS FAMILY MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831656354
- **Authorized official:** LISA HALFORD (COORDINATOR)
- **Authorized official phone:** (601) 807-9550

## Contact information

- **Practice address:** 821 MAIN ST, FAYETTE, MS 39069-5695
- **Practice address phone:** (601) 809-0882
- **Practice address fax:** (601) 809-0883
- **Mailing address:** PO BOX 91, FAYETTE, MS 39069-0091
- **Mailing address phone:** (601) 809-0882

## Taxonomy

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

## Other

- **Enumeration date:** 02/21/2019
- **Last updated:** 07/22/2021