Provider Demographics
NPI:1639539463
Name:JFMC TAYLORSVILLE, LLC
Entity Type:Organization
Organization Name:JFMC TAYLORSVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-425-0092
Mailing Address - Street 1:403 PINE ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39168-5528
Mailing Address - Country:US
Mailing Address - Phone:601-785-0202
Mailing Address - Fax:601-785-0205
Practice Address - Street 1:403 PINE ST
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:MS
Practice Address - Zip Code:39168-5528
Practice Address - Country:US
Practice Address - Phone:601-478-5020
Practice Address - Fax:601-785-0205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONES FAMILY MEDICINE CLINIC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-07
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care