Home » Mississippi » 38737 » Shaw Family Medical, Llc

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.

physician-icon Basic Information

Practice Location 189 N Main St, Drew, MS 38737-3146, US
Practice Location Phone662-745-6638
Practice Location Fax662-745-8480
Legal Business NameSHAW FAMILY MEDICAL, LLC
Other Organization NameGOUGH'S FAMILY MEDICAL CLINIC
Other Organization Name TypeDoing Business As Name
NPI ?1043665532
Entity TypeOrganization
Enumeration Date ? May 3, 2016
Last Update Date ? May 3, 2016
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Shaw Family Medical, Llc

SpecialtySpecializationLicenseLicense State
Nurse PractitionerFamily R872155Mississippi

legacy-id-icon Legacy Provider IDs of Shaw Family Medical, Llc

Provider IdIssuer StateIssuer TypeIssuer
04406222MississippiMedicaid

official-icon 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/PositionOWNER
Authorized Official Phone Number662-745-6638