Organization
PHYNET, INC
Active
Other names
Jefferson Life Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FORD (PRESIDENT)
(903) 247-0484
Entity
Organization
Contact information
Practice address
219 N POLK ST, JEFFERSON, TX 75657-2131
(903) 247-0484
(903) 247-0485
Mailing address
4002 TECHNOLOGY CTR, LONGVIEW, TX 75605-2697
(903) 247-0484
(903) 247-0485
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2009
Last updated
03/19/2025
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