Organization
FAMILY MEDICAL CLINIC OF CLEVELAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD JAMES BLACKWOOD M.D. (PRESIDENT)
(662) 843-2721
Entity
Organization
Contact information
Practice address
803 1ST ST, CLEVELAND, MS 38732-2309
(662) 843-2721
(662) 846-1728
Mailing address
803 1ST ST, CLEVELAND, MS 38732-2309
(662) 843-2721
(662) 846-1728
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855837
MS
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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