OrganizationActive
Chickasaw Fmc
NPI 1710101902 · Family Medicine Physician · Okolona, MS
Provider details
- NPI number
- 1710101902
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Chris Dedeaux, Clinic Administrator(622) 256-7112
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
518 West Dr
Okolona, MS 38860-1624
Phone: (662) 447-2255
Street-level locationGet directions
Mailing address
123 Main St N
Amory, MS 38821-3416
Registry dates
- Enumerated
- 2007-04-12
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.