Organization
G A CARMICHAEL FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS G COTTEN (ASST FINANCE DIRECTOR)
(601) 859-5213
Entity
Organization
Contact information
Practice address
1421 E PEACE ST STE B, CANTON, MS 39046-4938
(601) 855-2516
(601) 859-8771
Mailing address
PO BOX 588, CANTON, MS 39046-0588
(601) 859-5213
(601) 859-8771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03971398
—
MS
Enumeration date
01/02/2007
Last updated
02/08/2008
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