Organization
MADISON RIDGELAND CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA R PARKER (OFFICE MANAGER)
(601) 856-2598
Entity
Organization
Contact information
Practice address
297 HIGHWAY 51, SUITE B, RIDGELAND, MS 39157-3423
(601) 856-2598
(601) 856-4459
Mailing address
297 HIGHWAY 51, SUITE B, RIDGELAND, MS 39157-3423
(601) 856-2598
(601) 856-4459
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09008705
—
MS
Enumeration date
08/31/2006
Last updated
08/22/2020
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