Organization
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
Active
Parent organization
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
Other names
Internal Medicine and Pediatric Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
Authorized official
RACHEL MARIE THOMAS CPC (BILLING MANAGER/CREDENTIALING)
(662) 534-0898
Entity
Organization
Contact information
Practice address
119 CITY MARKET DR, SALTILLO, MS 38866-7002
(662) 534-0898
(662) 534-8905
Mailing address
118 FAIRFIELD DR, NEW ALBANY, MS 38652-3107
(662) 534-0898
(662) 534-8905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003756231
—
MS
Enumeration date
01/09/2023
Last updated
05/29/2024
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