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Organization
DESOTO PRIMARY CARE CLINIC, PLLC
Active
Organization
DESOTO PRIMARY CARE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAJU A. KUMAR M.D. (SOLE OWNER)
(901) 517-9171
Entity
Organization
Contact information
Practice address
6942 AUTUMN OAKS DR, OLIVE BRANCH, MS 38654-9379
(901) 517-9171
Mailing address
6942 AUTUMN OAKS DR, OLIVE BRANCH, MS 38654-9379
(901) 517-9171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18277
MS
Other
Enumeration date
10/14/2006
Last updated
08/22/2020
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