MEDICARE: DAVIS FAMILY HEALTH CARE

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	R870049	MS

General Provider Information

NPI Number	:	1760810287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVIS FAMILY HEALTH CARE

Provider Business Mailing Address
First Line	:	162 FEATHER LN STE E
Second Line	:
City	:	CANTON
State	:	MS
Zip	:	39046-8510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	162 FEATHER LN STE E
Second Line	:
City	:	CANTON
State	:	MS
Zip	:	39046-8510
Country	:	US
Telephone Number	:	601-502-3894
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	MS. JORRI DAVIS
Credential	:	FNP-C
Telephone Number	:	601-502-3894

Provider Enumeration Date	:	10/18/2013
Last Update Date	:	10/18/2013

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Directions to “DAVIS FAMILY HEALTH CARE ” Practice Location

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