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General NPI Number Information
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NPI Number | 1164682464
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Entity Type | Organization
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Legal Business Name | HARISH M. MADNANI M.D.P.C
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 251 HOSPITAL DR B
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City | TYLERTOWN
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State | MS
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Zip | 39667-2025
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Country | US
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Telephone | 601-876-6006
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Fax | 601-876-3603
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Provider Business Mailing Address
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Address Line | 251 HOSPITAL DR B
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City | TYLERTOWN
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State | MS
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Zip | 39667-2025
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Country | US
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Telephone | 601-876-6006
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Fax | 601-876-3603
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARISH M MADNANI
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Credential | M.D.
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Telephone | 601-876-6006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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