| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/13/2014 |
| Last Update Date | 01/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942606256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
North Mississippi Medical Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040a S. Madison St, Tupelo, MS 38801 Phone: 662-377-5290 Fax: 662-377-5291 | |
North Mississippi Medical Center Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
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 | |
North Mississippi Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 S Gloster St Fl 4, Tupelo, MS 38801 Phone: 662-377-2395 Fax: 662-377-2397 | |
North Mississippi Medical Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1680 S Green St, Tupelo, MS 38804 Phone: 662-377-2189 Fax: 662-377-2263 |