Physician Practice of Madison, PC
Physician Practice of Madison, PC provides Specialist services in Vicksburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2016.
- Licensed in
- MS
- In the registry since
- 2016
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1111 N Frontage Rd Fl 2Vicksburg, MS 39180-5102 Not confirmed with CMS for 10 years — call before visiting
Phone: (412) 721-2417
Fax: (601) 510-2367
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 21500 (MS) |
|---|
Record details
| NPI number | 1114476389 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shahjahan Sultan — Ceo · (412) 721-2417 |
| Other names | Physician Practice Of Madison, Pc |
| NPI enumerated | September 28, 2016 |
| Last updated in NPPES | September 28, 2016 |
| Mailing address | 6 Eastbrooke Cir, Madison, MS 39110-6537 |
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