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General NPI Number Information
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NPI Number | 1811006901
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Entity Type | Individual
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Provider Name | CHITRA S. MANI MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 785 OHIO AVE STE 3E
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City | CLARKSDALE
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State | MS
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Zip | 38614-6215
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Country | US
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Telephone | 662-351-0702
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Fax | 662-351-0703
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Provider Business Mailing Address
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Address Line | 785 OHIO AVE STE 3E
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City | CLARKSDALE
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State | MS
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Zip | 38614-6215
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Country | US
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Telephone | 662-351-0702
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Fax | 662-351-0703
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27663
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 050538
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License Number State | GA
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