Organization
IVANCIC PEDIATRIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MITZI PARSONS (OFFICE MANAGER)
(662) 840-6026
Entity
Organization
Contact information
Practice address
499 GLOSTER CREEK VLG, SUITE H-3, TUPELO, MS 38801-4600
(662) 840-6026
(662) 840-6030
Mailing address
499 GLOSTER CREEK VLG, SUITE H-3, TUPELO, MS 38801-4600
(662) 840-6026
(662) 840-6030
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/13/2014
Last updated
01/23/2019
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