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NPI Code Detail

MEDICARE: G A CARMICHAEL FAMILY HEALTH CENTER, INC.

MEDICARE: G A CARMICHAEL FAMILY HEALTH CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1043974033
Entity Type Code : Organization
Provider Name (Legal Business Name) : G A CARMICHAEL FAMILY HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : 1668 W PEACE ST
Second Line :
City : CANTON
State : MS
Zip : 39046-5332
Country : US
Telephone Number : 601-859-5213
Fax Number : 601-859-5771
Provider Business Practice Location Address
First Line : 303 W FRANKLIN ST
Second Line :
City : CARTHAGE
State : MS
Zip : 39051-3703
Country : US
Telephone Number : 601-859-5213
Fax Number : 601-859-8771
Authorized Official
Title or Position : CHIEF OPERATION OFFICER
Name : MR. JOSEPH DAVIS
Credential : MHA
Telephone Number : 601-859-5213
Provider Enumeration Date : 10/26/2021
Last Update Date : 10/26/2021

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Directions to “G A CARMICHAEL FAMILY HEALTH CENTER, INC. ” Practice Location

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