Provider Demographics
NPI:1568158913
Name:WEBB FAMILY MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:WEBB FAMILY MEDICAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NERREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-404-2901
Mailing Address - Street 1:2222 JACKSON AVE W
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5409
Mailing Address - Country:US
Mailing Address - Phone:662-380-5560
Mailing Address - Fax:
Practice Address - Street 1:2222 JACKSON AVE W
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5409
Practice Address - Country:US
Practice Address - Phone:662-380-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEBB FAMILY MEDICAL CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty