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Organization

ROSEDALE FAMILY MEDICAL CENTER, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN WILLIAM LEWIS JR. M.D. (PRESIDENT)
(662) 759-6806
Entity
Organization

Contact information

Practice address
512 LEVEE ST., ROSEDALE, MS 38769-0310
(662) 759-6806
(662) 759-6771
Mailing address
P.O.BOX 310, ROSEDALE, MS 38769-0310
(662) 759-6806
(662) 759-6771

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09592
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09014540
MS
Enumeration date
08/15/2006
Last updated
04/29/2008
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