| Family First Clinic Of Clarksdale, Pllc | |
|
1015 Lee Dr Suite 13 Clarksdale MS 38614-3698 | |
| (901) 737-1992 | |
| (901) 309-8784 |
| Full Name | Family First Clinic Of Clarksdale, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1015 Lee Dr, Clarksdale, Mississippi |
| Authorized Official Name and Position | Paula Aldridge (ADMINISTRATOR) |
| Authorized Official Contact | 9017371992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family First Clinic Of Clarksdale, Pllc 1015 Lee Dr Suite 13 Clarksdale MS 38614-3698 Ph: (901) 737-1992 | Family First Clinic Of Clarksdale, Pllc 1015 Lee Dr Suite 13 Clarksdale MS 38614-3698 Ph: (901) 737-1992 |
| NPI Number | 1215206016 |
|---|---|
| Provider Enumeration Date | 12/22/2011 |
| Last Update Date | 12/22/2011 |
| Medicare PECOS PAC ID | 6800054297 |
|---|---|
| Medicare Enrollment ID | O20120214000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215206016 | NPI | - | NPPES |
| 4258565 | Other | MS | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vernon Thomas Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427073170 PECOS PAC ID: 5890713416 Enrollment ID: I20051102000811 |
| Provider Name | Dallas M Earnest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376752832 PECOS PAC ID: 4789753252 Enrollment ID: I20110119000394 |
| Provider Name | Christopher John Ferracci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760929939 PECOS PAC ID: 7113289174 Enrollment ID: I20180403000795 |
| Provider Name | Cody Renaldo Gullick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205319530 PECOS PAC ID: 3678826716 Enrollment ID: I20181019000351 |
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