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Organization
NATCHEZ PEDIATRIC CLINIC PLLC
Active
Organization
NATCHEZ PEDIATRIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M MAYO (BUSINESS MANAGER)
(601) 442-5439
Entity
Organization
Contact information
Practice address
136 JEFFERSON DAVIS BLVD., SUITE A, NATCHEZ, MS 39120
(601) 442-5439
(601) 442-3755
Mailing address
PO BOX 17918, NATCHEZ, MS 39122-7918
(601) 442-5439
(601) 442-3755
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015226
—
MS
05
—
1445967
—
LA
Enumeration date
09/26/2006
Last updated
08/22/2020
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