# NARAYANAN PEDIATRIC CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043244163
- **Authorized official:** MRS. CATHY A DODGE (LPN OFFICE SUPERVISOR)
- **Authorized official phone:** (662) 895-9498

## Contact information

- **Practice address:** 3964 GOODMAN, STE 133, SOUTHAVEN, MS 38672
- **Practice address phone:** (662) 895-9498
- **Practice address fax:** (662) 890-4547
- **Mailing address:** PO BOX 170 DEPT 150, SOUTHAVEN, MS 38671
- **Mailing address phone:** (662) 895-9498
- **Mailing address fax:** (662) 890-4547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 08/22/2020