Organization
WEBSTER FAMILY PRACTICE
Active
Parent organization
WEBSTER URGENT CARE LLC
Other names
Webster Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEBSTER URGENT CARE LLC
Authorized official
MR. CHAD GARNETT (MANAGER)
(662) 634-3089
Entity
Organization
Contact information
Practice address
24849 MS HIGHWAY 15, MATHISTON, MS 39752-6900
(662) 634-3089
(662) 634-3063
Mailing address
PO BOX 190, MATHISTON, MS 39752-0190
(662) 634-3089
(662) 634-3063
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122955
FICTITIOUS NAME
MS
Enumeration date
03/26/2019
Last updated
05/19/2021
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