Organization
PHYNET, INC
Active
Parent organization
PHYNET INC
Other names
Jefferson Life Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYNET INC
Authorized official
JOHN D. FORD (PRESIDENT)
(903) 247-0484
Entity
Organization
Contact information
Practice address
219 N POLK ST, JEFFERSON, TX 75657-2131
(903) 665-2600
(903) 665-2608
Mailing address
4002 TECHNOLOGY CTR, LONGVIEW, TX 75605-2697
(903) 247-0484
(903) 247-0485
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159694201
—
TX
Enumeration date
05/19/2008
Last updated
03/19/2025
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