Organization
LIGHTHOUSE PEDIATRIC & AFTER HOURS CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMY LASHELLE SIMS M.D. (CEO)
(601) 488-4171
Entity
Organization
Contact information
Practice address
501 SPRINGRIDGE RD, CLINTON, MS 39056-5633
(601) 488-4171
(601) 488-4175
Mailing address
501 SPRINGRIDGE RD, CLINTON, MS 39056-5633
(601) 488-4171
(601) 488-4175
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16949
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04583552
—
MS
Enumeration date
09/24/2012
Last updated
09/24/2012
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