Chickasaw Fmc
NPI #1710101902 in Okolona, Mississippi
Provider Information
- NPI Number
- 1710101902
- Entity Type
- Organization
- Organization Name
- Chickasaw Fmc
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 12, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 518 WEST DR
- City
- Okolona
- State
- Mississippi
- ZIP Code
- 38860-1624
- Phone
- (662) 447-2255
Authorized Official
- Name
- CHRIS DEDEAUX
- Title
- CLINIC ADMINISTRATOR
- Phone
- (622) 256-7112
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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