Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Reservoir Family Medical Clinic, PA

Organization Family Medicine Physician · NPI 1770929713

Reservoir Family Medical Clinic, PA provides Family Medicine Physician services 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 Not confirmed with CMS for 13 years — call before visiting
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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