Individual
MS. TERRY ANN MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
330 NORTH BROAD ST, FOREST, MS 39074
(601) 469-4151
(601) 469-3681
Mailing address
173 K & B LANE, MAGEE, MS 39111
(601) 469-4151
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
10554
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010446
—
MS
Enumeration date
05/04/2007
Last updated
09/19/2016
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