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Organization

FAMILY MEDICINE ASSOCIATES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JULIUS KEITH SPEED DO (PRESIDENT)
(601) 876-5835
Entity
Organization

Contact information

Practice address
200 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-5835
(601) 876-5295
Mailing address
200 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-5835
(601) 876-5295

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11133
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0114413
MS
Enumeration date
03/25/2010
Last updated
03/25/2010
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