Organization
G A CARMICHAEL FAMILY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L. COLEMAN JR. ED.D. (CEO)
(601) 859-5213
Entity
Organization
Contact information
Practice address
644 FINNEY ROAD, CANTON, MS 39046
(601) 859-0579
(601) 859-8771
Mailing address
PO BOX 588, CANTON, MS 39046-0588
(601) 859-5213
(601) 859-8771
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015906
—
MS
Enumeration date
01/02/2007
Last updated
06/25/2018
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