| Canton Family Clinic Inc. | |
|
120 E Academy St Canton MS 39046-4502 | |
| (601) 859-2611 | |
| Not Available |
| Full Name | Canton Family Clinic Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 120 E Academy St, Canton, Mississippi |
| Authorized Official Name and Position | Jerry Lousteau (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 6018592611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Family Clinic Inc. 120 E Academy St Canton MS 39046-4502 Ph: () - | Canton Family Clinic Inc. 120 E Academy St Canton MS 39046-4502 Ph: (601) 859-2611 |
| NPI Number | 1902088453 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 03/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902088453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 09015552 (Mississippi) | Primary |
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