Organization
SHAW FAMILY MEDICAL, LLC
Active
Other names
Shaw Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
NORA GOUGH-DAVIS (PARTNER)
(662) 754-3301
Entity
Organization
Contact information
Practice address
112 W PEELER AVE, SHAW, MS 38773-8710
(662) 754-3301
(662) 754-3304
Mailing address
PO BOX 299, SHAW, MS 38773-0299
(662) 754-3301
(662) 654-3304
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2012
Last updated
02/22/2017
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