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

Caledonia Community Clinic, LLC

Organization Family Medicine Physician · NPI 1619552130

Caledonia Community Clinic, LLC provides Family Medicine Physician services in Caledonia, Mississippi. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

171 S St
Caledonia, MS 39740-8587
Phone: (662) 855-0080
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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

Record details

NPI number1619552130
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Hudson — Fnp-C · (662) 251-3451
NPI enumeratedMarch 16, 2021
Last updated in NPPESMarch 16, 2021
Certification dateMarch 16, 2021
Mailing addressPo Box 217, Caledonia, MS 39740-0217

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