MEDICARE: JULIA E RILEY MD

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	208000000X	Pediatrics Physician	21727	MS

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366541872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA E RILEY MD

Provider Business Mailing Address
First Line	:	1001 HOLLAND AVE
Second Line	:	NESHOBA COUNTY GENERAL HOSPITAL
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2161
Country	:	US
Telephone Number	:	601-656-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 E MAIN ST
Second Line	:	NESHOBA PEDIATRICS SUITE 6
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2348
Country	:	US
Telephone Number	:	601-656-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	03/26/2014

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Directions to “ JULIA E RILEY MD” Practice Location

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