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ROME SHERROD II MD NPI 1124201892


NPI Information

NPI: 1124201892
Provider Name: ROME SHERROD II MD

Other Name: TRI-STATE HEALTHCARE FOR WOMEN

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
7600 AIRWAYS BLVD STE B
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-9370
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ROME SHERROD II MD is a medical specialty clinic center in Southaven, MS. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). ROME SHERROD II MD NPI is 1124201892. The provider is registered as an organization entity type.
The provider Other Name Is Tri-state Healthcare For Women.

The provider's business location address is:

7600 AIRWAYS BLVD STE B
SOUTHAVEN, MS
ZIP 38671-138
Phone: (662) 349-9370
Fax: (662) 349-9372

The provider's authorized official is Rome Sherrod .
The authorized official title is Owner and has the following contact phone number (662) 349-9370.

The enumeration date for this NPI number is 12/17/2007 and was last updated on 6/10/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1427842189OTHERMISSISSIPPIBLUE CROSS BLUE SHIELD MS
2160000623MEDICARE PINMISSISSIPPI
32008964OTHERTENNESSEEBLUE CROSS BLUE SHIELD
40013667MEDICAIDMISSISSIPPI
5B59327MEDICARE UPINMISSISSIPPI
6C03035MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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