Provider Demographics
NPI:1548394562
Name:FAMILY CARE, P.C.
Entity Type:Organization
Organization Name:FAMILY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-627-4914
Mailing Address - Street 1:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38025-0688
Mailing Address - Country:US
Mailing Address - Phone:731-627-4914
Mailing Address - Fax:731-627-4938
Practice Address - Street 1:108 EAST DR
Practice Address - Street 2:
Practice Address - City:NEWBERN
Practice Address - State:TN
Practice Address - Zip Code:38059-1404
Practice Address - Country:US
Practice Address - Phone:731-627-4914
Practice Address - Fax:731-627-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3720750Medicare ID - Type Unspecified