Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Reservoir Family Medical Clinic, PA

Organization Family Medicine Physician · NPI 1770929713

Reservoir Family Medical Clinic, PA is a Family Medicine Physician in Flowood, Mississippi. Licensed in Mississippi. Registered with an NPI since 2013.

Licensed in
MS
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1679 Old Fannin Rd Ste E
Flowood, MS 39232-8101
Phone: (601) 992-6511
Fax: (601) 992-5684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 09099 (MS)

Record details

NPI number1770929713
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Crenshaw — Owner/Physican · (601) 992-6511
NPI enumeratedMay 17, 2013
Last updated in NPPESMay 29, 2013
Mailing address1679 Old Fannin Rd Ste E, Flowood, MS 39232-8101

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