PEDIATRIC & ADOLESCENT CLINIC LLC NPI 1952163206

NPI Information

  • NPI: 1952163206
  • Provider Name: PEDIATRIC & ADOLESCENT CLINIC LLC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Address: 107 N MARTIN LUTHER KING JR ST
    NATCHEZ, MS
    ZIP 39120
  • Phone: (601) 442-7676

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NPI Details

PEDIATRIC & ADOLESCENT CLINIC LLC is a rural health clinic center in Natchez, MS. PEDIATRIC & ADOLESCENT CLINIC LLC NPI is 1952163206. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

107 N MARTIN LUTHER KING JR ST
NATCHEZ, MS
ZIP 39120-356
Phone: (601) 442-7676
Fax: (601) 442-9590

The provider's authorized official is David A Timm .
The authorized official title is Medical Director and has the following contact phone number (601) 442-7676.

The enumeration date for this NPI number is 1/23/2024 and was last updated on 10/27/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsNo
2261QR1300XClinic/CenterRural HealthYes

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: 11/21/2025

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