Organization
FAMILY MEDICAL CLINIC OF NORTH MS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L SKINNER DO (VICE PRESIDENT)
(662) 850-5555
Entity
Organization
Contact information
Practice address
3451 GOODMAN RD, STE 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
(662) 890-8899
Mailing address
3451 GOODMAN RD, STE 115, SOUTHAVEN, MS 38672-9304
(662) 890-5555
(662) 890-8899
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK6296
PALMETTO
MS
Enumeration date
05/24/2006
Last updated
02/06/2008
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