Family Medicine Associates, PA
Organization Active NPI Family Medicine Physician · Tylertown, MS
NPI 1033433628 · NPPES record last updated Mar 25, 2010
Key facts
- NPI
- 1033433628
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11133 (MS)
- Legal business name
- FAMILY MEDICINE ASSOCIATES, PA
- Practice address
- 200 Hospital Dr
Tylertown, MS 39667-2020 - Phone
- (601) 876-5835
- Fax
- (601) 876-5295
- NPI assigned
- Mar 25, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Julius Keith Speed, DO
- Title
- President
- Phone
- (601) 876-5835
National Provider Directory
Locations
200 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-5303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 11133 | MS | Yes |
Addresses
Primary practice location
200 Hospital Dr
Tylertown, MS 39667-2020
Mailing address
200 Hospital Dr
Tylertown, MS 39667-2020
Phone (601) 876-5835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0114413 | Medicaid | MS |
Other providers in Tylertown, MS
- Ashlei Chulette Ellzey
- Essential Care LLC
- Family Health Care Clinic, Inc.
- Family Health Care Clinic, Inc.
- Family Health Care Clinic, Inc.
- Yolanda Fortenberry
- Posavanike S Ganaraj
- Shuwanda Nicole Gatlin
- Harish M. Madnani M.D.P.C
- Hattiesburg Clinic, PA
All providers in Tylertown, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.