Shaw Family Medical, Llc
Shaw Family Medical, Llc is a health care provider in Drew, MS. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location|| 189 N Main St, Drew, MS 38737-3146, US |
|Practice Location Phone||662-745-6638|
|Practice Location Fax||662-745-8480|
|Legal Business Name||SHAW FAMILY MEDICAL, LLC|
|Other Organization Name||GOUGH'S FAMILY MEDICAL CLINIC|
|Other Organization Name Type||Doing Business As Name|
|Enumeration Date ? ||May 3, 2016|
|Last Update Date ? ||May 3, 2016|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
Specialties & Licenses of Shaw Family Medical, Llc
|Specialty||Provider Type||Specialization||License||License State|
|Nurse Practitioner||Physician Assistants & Advanced Practice Nursing Providers||Family ||R872155||Mississippi|
Legacy Provider IDs of Shaw Family Medical, Llc
|Provider Id||Issuer State||Issuer Type||Issuer|
Authorized Official of Shaw Family Medical, Llc
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Shaw Family Medical, Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official || Nora Gough-davis (FNP)|
|Authorized Official Title/Position||OWNER|
|Authorized Official Phone Number||662-745-6638|