# SOUTHERN FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1982608691
- **Authorized official:** DR. JASON GREGORY BEASLEY MD (OWNER)
- **Authorized official phone:** (601) 765-9393

## Contact information

- **Practice address:** 603 S HOLLY AVE, COLLINS, MS 39428-3801
- **Practice address phone:** (601) 765-9393
- **Practice address fax:** (601) 765-9363
- **Mailing address:** 606 GERALD MCRANEY ST, COLLINS, MS 39428-3801
- **Mailing address phone:** (601) 765-9393
- **Mailing address fax:** (601) 765-9363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/09/2005
- **Last updated:** 01/22/2019