Healthcare Provider Details

I. General information

NPI: 1306502943
Provider Name (Legal Business Name): MISSISSIPPI PEDIATRIC ENDOCRINE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 TRACELAND DR STE A
TUPELO MS
38801-4240
US

IV. Provider business mailing address

2625 TRACELAND DR STE A
TUPELO MS
38801-4240
US

V. Phone/Fax

Practice location:
  • Phone: 662-432-0961
  • Fax: 662-432-0965
Mailing address:
  • Phone: 664-432-0961
  • Fax: 664-432-0965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SARA A SILVER
Title or Position: SOLE OWNER
Credential: D.O.
Phone: 662-432-0961