Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Childrens Clinic of Clarksdale PA

Organization Pediatrics Physician · NPI 1497834030

Childrens Clinic of Clarksdale PA provides Pediatrics Physician services in Clarksdale, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2245 N State St
Clarksdale, MS 38614
Phone: (662) 627-4131
Fax: (662) 627-2702
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence R861078 (MS)
Pediatrics Physician Taxonomy 208000000X · Licence 07191 (MS)
Pediatrics Physician Taxonomy 208000000X · Licence 07070 (MS)

Record details

NPI number1497834030
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carole Mangrem — Partner · (662) 627-4131
NPI enumeratedNovember 3, 2006
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 1447, Clarksdale, MS 38614

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