Organization
FAMILY HEALTH CARE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARINA MARIE CLAYTON (CHIEF FINANCIAL OFFICER)
(601) 825-7280
Entity
Organization
Contact information
Practice address
1551 W GOVERNMENT ST, BRANDON, MS 39042
(601) 825-3163
(601) 825-7893
Mailing address
PO BOX 24116, JACKSON, MS 39225-4116
(601) 825-7280
(601) 825-8130
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014312
—
MS
Enumeration date
01/03/2008
Last updated
07/04/2018
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