Organization
ACORN PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIODUN F. BALOGUN MD (OWNER)
(601) 798-9987
Entity
Organization
Contact information
Practice address
1016 SIXTH AVE STE A, PICAYUNE, MS 39466-3804
(601) 798-5558
(601) 798-9915
Mailing address
PO BOX 1055, PICAYUNE, MS 39466-1055
(601) 798-5558
(601) 798-9915
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19061
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08437778
—
MS
05
—
1994596
—
LA
Enumeration date
07/21/2006
Last updated
04/10/2013
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