Organization
FAMILY FIRST CLINIC OF CLARKSDALE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DALLAS EARNEST FNP (OWNER)
(662) 592-4170
Entity
Organization
Contact information
Practice address
1015 LEE DR, SUITE 13, CLARKSDALE, MS 38614-3698
(662) 592-4170
(662) 269-0226
Mailing address
1015 LEE DR, SUITE 13, CLARKSDALE, MS 38614-3698
(901) 737-1992
(901) 309-8784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4258565
BLUE CROSS
MS
Enumeration date
12/22/2011
Last updated
10/17/2024
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