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General NPI Number Information
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NPI Number | 1366628927
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Entity Type | Organization
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Legal Business Name | PATIENTS' CHOICE MEDICAL CENTER OF HUMPHREYS COUNTY, LLC
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 500 CCC RD
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City | BELZONI
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State | MS
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Zip | 39038
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Country | US
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Telephone | 662-247-3874
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Fax |
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Provider Business Mailing Address
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Address Line | 500 CCC ROAD
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City | BELZONI
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State | MS
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Zip | 39038-0510
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Country | US
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Telephone | 662-247-3874
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RAY SHOEMAKER
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Credential |
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Telephone | 662-247-3874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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