Organization
FAMILY CARE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAMONICA ANTONETTE HODGES NP (OWNER/ADMINISTRATOR)
(662) 820-7780
Entity
Organization
Contact information
Practice address
1440 HIGHWAY 1 S, GREENVILLE, MS 38701-7140
(662) 820-7780
(888) 980-6547
Mailing address
PO BOX 3946, GREENVILLE, MS 38704-3946
(662) 820-7780
(888) 980-6547
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
901388
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09551264
—
MS
Enumeration date
04/01/2016
Last updated
04/01/2016
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