Organization
FAMILY CARE MEDICAL CLINIC, LLC
Active
Other names
Family Care Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SYLVIA O BLANCHARD CFNP (CEO)
(662) 840-4175
Entity
Organization
Contact information
Practice address
109 PARK GATE EXT, TUPELO, MS 38801-3038
(662) 840-4175
(662) 840-8279
Mailing address
109 PARK GATE EXT, TUPELO, MS 38801-3038
(662) 840-4175
(662) 840-8279
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R729086
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124764
—
MS
Enumeration date
12/13/2006
Last updated
08/22/2020
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