Organization
COMPREHENSIVE FAMILY MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT L SMITH NP-C (OWNER)
(662) 280-3428
Entity
Organization
Contact information
Practice address
3040 GOODMAN RD W, HORN LAKE, MS 38637-1189
(662) 280-3428
(662) 280-1736
Mailing address
3040 GOODMAN RD W, HORN LAKE, MS 38637-1189
(662) 280-3428
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A810353
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134450307
COMMERCIAL INSURANCE
MS
Enumeration date
12/20/2011
Last updated
12/20/2011
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