Healthcare Provider Details

I. General information

NPI: 1831619253
Provider Name (Legal Business Name): HOMETOWN HEALTH CARE OF MAGEE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 SIMPSON HIGHWAY 149 STE 400
MAGEE MS
39111-3570
US

IV. Provider business mailing address

376 SIMPSON HIGHWAY 149 STE 400
MAGEE MS
39111-3570
US

V. Phone/Fax

Practice location:
  • Phone: 601-849-1220
  • Fax: 601-849-5832
Mailing address:
  • Phone: 601-849-1220
  • Fax: 601-849-5832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY L LICHTE
Title or Position: CLINIC MANAGER
Credential:
Phone: 601-849-1226