MEDICARE: INDIRA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	10202	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CK4239	OTHER	MS	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316128762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIRA INC

Provider Business Mailing Address
First Line	:	12 PROFESSIONAL PKWY
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4113
Country	:	US
Telephone Number	:	601-856-2460
Fax Number	:	601-856-4687

Provider Business Practice Location Address
First Line	:	12 PROFESSIONAL PKWY
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4113
Country	:	US
Telephone Number	:	601-856-2460
Fax Number	:	601-856-4687

Authorized Official
Title or Position	:	OWNER
Name	:	INDIRA K VEERISETTY
Credential	:	MD
Telephone Number	:	601-856-2460

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	06/11/2008

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Directions to “INDIRA INC ” Practice Location

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