Organization
BAZ FAMILY MEDICAL CLINIC
Active
Other names
Baz Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE SHABAZZ NP (PRESIDEN)
(717) 421-5490
Entity
Organization
Contact information
Practice address
4310 CHICOT ST, PASCAGOULA, MS 39581-4700
(717) 421-5490
Mailing address
7922 LONGWOOD DR, GAUTIER, MS 39553-2629
(717) 421-5490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R885984
MS
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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