Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Parkside Pediatric Clinic, PC

Organization Pediatrics Physician · NPI 1477781169

Parkside Pediatric Clinic, PC provides Pediatrics Physician services in Jackson, Michigan. Licensed in Michigan. Registered with an NPI since 2009.

Licensed in
MI
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2100 4th St
Jackson, MI 49203-4518 Not confirmed with CMS for 17 years — call before visiting
Phone: (517) 787-4332
Fax: (517) 787-4861
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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 4301 031905 (MI)

Record details

NPI number1477781169
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Katikineni Rao — President · (517) 787-4332
NPI enumeratedJuly 1, 2009
Last updated in NPPESJuly 1, 2009
Mailing address2100 4th St, Jackson, MI 49203-4518

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