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Organization

WATERS FAMILY HEALTH CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMIE C WATERS CFNP (OWNER)
(662) 365-3253
Entity
Organization

Contact information

Practice address
305 MILL ST, BALDWYN, MS 38824
(662) 365-3253
(662) 365-3484
Mailing address
305 MILL ST, BALDWYN, MS 38824
(662) 365-3253
(662) 365-3484

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R574929
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03222231
MS
Enumeration date
01/22/2008
Last updated
01/22/2008
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