# COMMUNITY HEALTH CLINIC

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

## Provider details

- **NPI number:** 1982902458
- **Authorized official:** BOBBIE G MILLER (CEO)
- **Authorized official phone:** (601) 962-2576

## Contact information

- **Practice address:** 102 JULIA STREET, ISOLA, MS 38754
- **Practice address phone:** (662) 962-7923
- **Practice address fax:** (662) 962-2575
- **Mailing address:** P.O. BOX 553, ISOLA, MS 38754

## Taxonomy

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

## Other

- **Enumeration date:** 03/08/2011
- **Last updated:** 03/08/2011