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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