Ivancic Pediatric Clinic Pa | |
499 Gloster Creek Vlg Suite H-3 Tupelo MS 38801-4600 | |
(662) 840-6026 | |
(662) 840-6030 |
Full Name | Ivancic Pediatric Clinic Pa |
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Speciality | Clinic/center - Primary Care |
Location | 499 Gloster Creek Vlg, Tupelo, Mississippi |
Authorized Official Name and Position | Mitzi Parsons (OFFICE MANAGER) |
Authorized Official Contact | 6628406026 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ivancic Pediatric Clinic Pa 499 Gloster Creek Vlg Suite H-3 Tupelo MS 38801-4600 Ph: (662) 840-6026 | Ivancic Pediatric Clinic Pa 499 Gloster Creek Vlg Suite H-3 Tupelo MS 38801-4600 Ph: (662) 840-6026 |
NPI Number | 1942606256 |
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Provider Enumeration Date | 11/13/2014 |
Last Update Date | 01/23/2019 |
Identifier | Type | State | Issuer |
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1942606256 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-2386 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Varsity Dr, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |