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General NPI Number Information
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NPI Number | 1124119862
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PEDIATRIC CLINIC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2024 15TH ST 5TH FLOOR NORTH
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City | MERIDIAN
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State | MS
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Zip | 39301-4130
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Country | US
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Telephone | 601-693-2777
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Fax | 601-482-8219
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Provider Business Mailing Address
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Address Line | 2024 15TH ST 5TH FLOOR NORTH
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City | MERIDIAN
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State | MS
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Zip | 39301-4130
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Country | US
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Telephone | 601-693-2777
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. WILLIAM B SIMMONS
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Credential | M.D.
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Telephone | 601-693-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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