Organization
G A CARMICHAEL FAMILY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L. COLEMAN JR. ED.D. (CEO)
(601) 859-5213
Entity
Organization
Contact information
Practice address
110 N JERRY CLOWER BLVD, YAZOO CITY, MS 39194
(601) 859-5213
Mailing address
PO BOX 588, CANTON, MS 39046-0588
(601) 859-0289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
MS
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09928291
—
MS
Enumeration date
08/07/2007
Last updated
10/31/2023
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