Organization
SHAW COMMUNITY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARLA LEE GRAVES (ADMINISTRATOR)
(662) 332-8848
Entity
Organization
Contact information
Practice address
112 PEELER AVE, SHAW, MS 38773
(662) 754-2060
Mailing address
PO BOX 5097, GREENVILLE, MS 38704-5097
(662) 332-8848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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