Organization
CHAMPION FAMILY MEDICAL & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON CHAMPION (OWNER/MANAGER)
(251) 610-4041
Entity
Organization
Contact information
Practice address
303B HIGHWAY 90, BAY ST LOUIS, MS 39520-2832
(228) 467-4431
(228) 467-4443
Mailing address
303B HIGHWAY 90, BAY ST LOUIS, MS 39520-2832
(228) 467-4431
(228) 467-4443
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/12/2012
Last updated
03/12/2012
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