Family Medical Clinic Of Crystal Springs Pllc

LBN: Family Medical Clinic Of Crystal Springs Pllc
Family Medical Clinic Of Crystal Springs Pllc is an health care organization with primary practice located at 104 W Railroad Ave S , Crystal Springs MS 39059-2111. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Family Medical Clinic Of Crystal Springs Pllc can be contacted via phone (601) 892-3063, or through Ervin, James W via phone (601) 892-3063.

Contact Information

Primary practice address
104 W Railroad Ave S Crystal Springs MS 39059-2111
Phone: (601) 892-3063
Fax: (601) 892-3570
Website:
Map and Directions
Authorized official contact:
Name: Ervin, James W Doctor of Medicine (MD)
Phone: (601) 892-3063

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1205915998
LBN Legal business name Family Medical Clinic Of Crystal Springs Pllc
DBA Doing business as
Authorized official Ervin, James W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 3rd, 2006
Last updated Sep 30th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205915998 NPPES
Mississippi MEDICAID 06726832

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