| Family Wellness Clinic Llc | |
|
703b Farmer St Port Gibson MS 39150-2319 | |
| (601) 437-5668 | |
| (601) 437-4533 |
| Full Name | Family Wellness Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 703b Farmer St, Port Gibson, Mississippi |
| Authorized Official Name and Position | Tanya S Anderson (MEMBER) |
| Authorized Official Contact | 6014375668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Wellness Clinic Llc Po Box 726 Port Gibson MS 39150-0726 Ph: (601) 437-5668 | Family Wellness Clinic Llc 703b Farmer St Port Gibson MS 39150-2319 Ph: (601) 437-5668 |
| NPI Number | 1457544066 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 07/09/2021 |
| Medicare PECOS PAC ID | 6608963327 |
|---|---|
| Medicare Enrollment ID | O20071029000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457544066 | NPI | - | NPPES |
| 00122761 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 16897 (Mississippi) | Primary |
| Provider Name | Tanya S Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487708525 PECOS PAC ID: 7517980295 Enrollment ID: I20060109000586 |
Claiborne County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-3782 | |
Claiborne County School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 161 Ramsey Dr, Port Gibson, MS 39150 Phone: 601-437-4251 | |
Claiborne County Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2045 Highway 61 North, Port Gibson, MS 39150 Phone: 601-437-3049 Fax: 601-437-3051 | |
Claiborne County Family Health Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 880 Anthony St, 2045 Highway 61 North, Port Gibson, MS 39150 Phone: 601-437-0257 Fax: 601-437-3944 | |
Claiborne County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-5130 | |
Patients Choice Medical Center Of Claiborne County Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Mccomb Ave, Port Gibson, MS 39150 Phone: 601-437-5141 Fax: 601-437-3782 |