Provider Demographics
NPI:1164645479
Name:FAMILY MEDICINE CLINIC
Entity type:Organization
Organization Name:FAMILY MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-256-7112
Mailing Address - Street 1:404 GILMORE DR
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-3416
Mailing Address - Country:US
Mailing Address - Phone:662-256-3564
Mailing Address - Fax:662-256-3996
Practice Address - Street 1:404 GILMORE DR
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5414
Practice Address - Country:US
Practice Address - Phone:662-256-3564
Practice Address - Fax:662-256-3996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH MANAGMENT ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-11
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty