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Organization

SIDHU PEDIATRICS, LLC

Active
Other names
Desoto Children's Clinic - Olive Branch
Organization subpart
No

Provider details

NPI number
Authorized official
REUBEN SIDHU (ADMINISTRATOR)
(662) 349-6577
Entity
Organization

Contact information

Practice address
7145 GOODMAN ROAD, OLIVE BRANCH, MS 38654
(662) 333-5001
(662) 420-7063
Mailing address
7145 GOODMAN RD, OLIVE BRANCH, MS 38654-1904
(662) 333-5001
(662) 420-7063

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00016777
MS
05
07529722
MS
Enumeration date
07/10/2015
Last updated
04/06/2026
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