Reservoir Family Medical Clinic, PA
NPI #1770929713 in Flowood, Mississippi
Provider Information
- NPI Number
- 1770929713
- Entity Type
- Organization
- Organization Name
- Reservoir Family Medical Clinic, PA
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 17, 2013
- Last Updated
- May 29, 2013
Practice Location
- Address
- 1679 OLD FANNIN RD STE E
- City
- Flowood
- State
- Mississippi
- ZIP Code
- 39232-8101
- Phone
- (601) 992-6511
Authorized Official
- Name
- DR. CHARLES NAURICE CRENSHAW III, MD
- Title
- OWNER/PHYSICAN
- Phone
- (601) 992-6511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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