Organization
INDIRA INC
Active
Other names
MADISON RIDGELAND MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
INDIRA K VEERISETTY MD (OWNER)
(601) 856-2460
Entity
Organization
Contact information
Practice address
12 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4113
(601) 856-2460
(601) 856-4687
Mailing address
12 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4113
(601) 856-2460
(601) 856-4687
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10202
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00014170
—
MS
01
—
CK4239
MEDICARE RAILROAD
MS
Enumeration date
11/14/2007
Last updated
06/11/2008
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