| Internal Medicine & Pediatric Associates | |
|
6919 Old Canton Rd Ridgeland MS 39157-1268 | |
| (601) 956-0911 | |
| Not Available |
| Full Name | Internal Medicine & Pediatric Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 6919 Old Canton Rd, Ridgeland, Mississippi |
| Authorized Official Name and Position | Manisha Sethi (MANAGER) |
| Authorized Official Contact | 6019560911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine & Pediatric Associates 6919 Old Canton Rd Ridgeland MS 39157-1268 Ph: (601) 956-0911 | Internal Medicine & Pediatric Associates 6919 Old Canton Rd Ridgeland MS 39157-1268 Ph: (601) 956-0911 |
| NPI Number | 1558460642 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 01/13/2015 |
| Medicare PECOS PAC ID | 1052318177 |
|---|---|
| Medicare Enrollment ID | O20061103000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558460642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16465 (Mississippi) | Primary |
| 208000000X | Pediatrics | 16465 (Mississippi) | Secondary |
| Provider Name | Manisha Sethi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316046410 PECOS PAC ID: 1153350293 Enrollment ID: I20050809000268 |
| Provider Name | Jason Burl Hicks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023034097 PECOS PAC ID: 9436156551 Enrollment ID: I20061103000062 |
| Provider Name | Suzanne Webster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174068415 PECOS PAC ID: 3678832409 Enrollment ID: I20180124000113 |
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