Individual
SITESH RANEN ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5249
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5249
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
17714
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126077
—
MS
05
—
1127191
—
LA
Enumeration date
09/22/2006
Last updated
11/17/2008
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