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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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