Individual
DR. SRIDEVI ALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
332 HIGHWAY 12 W, KOSCIUSKO, MS 39090-3209
(662) 289-1800
(662) 289-2489
Mailing address
864 WILSON DR, SUITE C, RIDGELAND, MS 39157-4512
(601) 206-6100
(601) 206-6052
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22172
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05188833
—
MS
Enumeration date
07/23/2009
Last updated
04/03/2013
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