Healthcare Provider Details

I. General information

NPI: 1487747234
Provider Name (Legal Business Name): RHEUMATOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 N STATE ST STE 303
JACKSON MS
39202-2413
US

IV. Provider business mailing address

1190 N STATE ST STE 303
JACKSON MS
39202-2413
US

V. Phone/Fax

Practice location:
  • Phone: 601-360-1106
  • Fax: 601-360-1713
Mailing address:
  • Phone: 601-360-1106
  • Fax: 601-360-1713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: NIRUPA MOHANDAS
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 601-360-1106