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Organization

YAZOO FAMILY HEALTHCARE,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORI R LEDLOW (OFFICE MANAGER)
(662) 746-2113
Entity
Organization

Contact information

Practice address
307 E FIFTEENTH ST, YAZOO CITY, MS 39194-2631
(662) 746-2113
(662) 746-2115
Mailing address
307 E FIFTEENTH ST, YAZOO CITY, MS 39194-2631
(662) 746-2113
(662) 746-2115

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011803
MS
05
00124725
MS
05
00126250
MS
05
03278771
MS
01
425460633B
BLUE CROSS BLUE SHIELD
MS
01
587229770A
BLUE CROSS BLUE SHIELD
MS
01
587571939
BLUE CROSS BLUE SHIELD
MS
Enumeration date
08/17/2006
Last updated
06/04/2014
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