Mallory Community Health
NPI #1013034636 in Canton, Mississippi
Provider Information
- NPI Number
- 1013034636
- Entity Type
- Organization
- Organization Name
- Mallory Community Health
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Mar 26, 2007
- Last Updated
- Aug 29, 2024
Practice Location
- Address
- 276 NISSAN PARKWAY, BUILDING C
- Address 2
- SUITE 100
- City
- Canton
- State
- Mississippi
- ZIP Code
- 39046
- Phone
- (601) 855-5275
Authorized Official
- Name
- MR. CLYDE ROZELL CHAPMAN II, MD
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (662) 834-1857
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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