Organization
PRIME HEART AND VASCULAR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDAR R JAGTAP DO (PROVIDER)
(317) 201-2307
Entity
Organization
Contact information
Practice address
1310 HIGHWAY 72 E, CORINTH, MS 38834-6524
(317) 201-2307
Mailing address
PO BOX 1470, CORINTH, MS 38835-1470
(317) 201-2307
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03005201
—
MS
Enumeration date
07/14/2020
Last updated
07/07/2021
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