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SHAW FAMILY MEDICAL LLC NPI 1750642633


NPI Information

NPI: 1750642633
Provider Name: SHAW FAMILY MEDICAL, LLC

Doing Business As: SHAW FAMILY MEDICAL

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 25D2042850

Address:
112 W PEELER AVE
SHAW, MS
ZIP 38773
Phone: (662) 754-3301
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SHAW FAMILY MEDICAL, LLC is a clinic center in Shaw, MS. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SHAW FAMILY MEDICAL, LLC NPI is 1750642633. The provider is registered as an organization entity type.
The provider Is Doing Business As Shaw Family Medical.

The provider's business location address is:

112 W PEELER AVE
SHAW, MS
ZIP 38773-710
Phone: (662) 754-3301
Fax: (662) 754-3304

The provider's authorized official is Nora Gough-davis .
The authorized official title is Partner and has the following contact phone number (662) 754-3301.

The CLIA number assigned to this NPI record is 25D2042850 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/6/2012 and was last updated on 2/22/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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