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SENATOBIA CHILDRENS CLINIC PC NPI 1326261843


NPI Information

NPI: 1326261843
Provider Name: SENATOBIA CHILDRENS CLINIC PC

Doing Business As: DESOTO CHILDRENS CLINIC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 25D0975412

Address:
7276 SOUTHCREST PKWY
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-6577
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SENATOBIA CHILDRENS CLINIC PC is a pediatrics in Southaven, MS. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SENATOBIA CHILDRENS CLINIC PC NPI is 1326261843. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Desoto Childrens Clinic.

The provider's business location address is:

7276 SOUTHCREST PKWY
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 349-6577
Fax: (662) 349-6562

The provider's authorized official is Desh Deepak Sidhu .
The authorized official title is President and has the following contact phone number (662) 349-6577.

The CLIA number assigned to this NPI record is 25D0975412 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 5/2/2023.


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
1208000000XPediatricsYes

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
109015155MEDICAIDMISSISSIPPI

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: 4/28/2024

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