MEDICARE: NEW HOPE FAMILY MEDICAL CLINIC

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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1699400184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HOPE FAMILY MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	2110 LAKE LOWNDES RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9655
Country	:	US
Telephone Number	:	662-798-0445
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 LAKE LOWNDES RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9655
Country	:	US
Telephone Number	:	662-798-0445
Fax Number	:	833-962-3812

Authorized Official
Title or Position	:	NURSE PRACTITIONER/OWNER
Name	:	MRS. CARRIE DOZIER
Credential	:	NP-C
Telephone Number	:	662-798-0445

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	12/05/2022

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Directions to “NEW HOPE FAMILY MEDICAL CLINIC ” Practice Location

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