Lafayette Pediatric Clinic

Organization Pediatric Adolescent Medicine Physician · NPI 1144418609

Lafayette Pediatric Clinic provides Pediatric Adolescent Medicine Physician services in Oxford, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in: MS
In the registry since: 2007

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Practice location Address checks out

2166 S Lamar Blvd
Oxford, MS 38655-5224 Not confirmed with CMS for 16 years — call before visiting
Phone: (662) 236-3939
Fax: (662) 236-3924

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary)	Taxonomy 2080A0000X · Licence 17111 (MS)

Record details

NPI number	1144418609
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Tanya Fitts — Owner · (662) 236-3939
NPI enumerated	October 10, 2007
Last updated in NPPES	March 17, 2010
Mailing address	2166 S Lamar Blvd, Oxford, MS 38655-5224