Organization
WEBB FAMILY MEDICAL CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD NERREN III CPA (CEO)
(662) 714-4460
Entity
Organization
Contact information
Practice address
1200 CENTRAL ST, WATER VALLEY, MS 38965-1904
(662) 714-4460
(662) 714-4480
Mailing address
1200 CENTRAL ST, WATER VALLEY, MS 38965-1904
(662) 714-4460
(662) 714-4480
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548357981
NPPES
—
01
—
17582
MISSISSIPPI STATE BOARD OF MEDICAL LICENSURE
MS
Enumeration date
12/10/2019
Last updated
09/02/2021
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