Organization
PRIMARY FAMILY MEDICAL CLINIC
Active
Other names
Primary Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA FAYE THOMAS DNP, (FAMILY NURSE PRACTITIONER)
(601) 372-1221
Entity
Organization
Contact information
Practice address
100 MARKER PLACE DR. STE D, BYRAM, MS 39272
(601) 672-4661
(769) 300-8068
Mailing address
100 MARKETPLACE DR STE D, BYRAM, MS 39272-8974
(601) 372-1221
(769) 300-8086
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R772161
MS
Other
Enumeration date
05/04/2018
Last updated
10/29/2019
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