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Individual

DR. POSAVANIKE S GANARAJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-4961
(601) 876-9172
Mailing address
250 HOSPITAL DR, PO BOX465, TYLERTOWN, MS 39667-2020
(601) 876-4961
(601) 876-9172

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07415
MS
261Q00000X
Clinic/Center
07415
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09016259
MS
Enumeration date
10/16/2006
Last updated
09/11/2025
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