Organization
TRINITY PEDIATRIC CLINIC
Active
Organization
TRINITY PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY U ROBERTSON MD (MANAGER)
(601) 376-2857
Entity
Organization
Contact information
Practice address
1860 CHADWICK DR, SUITE 205, JACKSON, MS 39204-3463
(601) 376-2857
Mailing address
1860 CHADWICK DR, SUITE 205, JACKSON, MS 39204-3463
(601) 376-2857
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118818
—
MS
Enumeration date
04/29/2011
Last updated
04/29/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up