Lafayette Pediatric Clinic

LBN: Lafayette Pediatric Clinic
Lafayette Pediatric Clinic is an health care organization with primary practice located at 2166 S Lamar Blvd , Oxford MS 38655-5224. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Lafayette Pediatric Clinic can be contacted via phone (662) 236-3939, or through Fitts, Tanya Jean via phone (662) 236-3939.

Contact Information

Primary practice address
2166 S Lamar Blvd Oxford MS 38655-5224
Phone: (662) 236-3939
Fax: (662) 236-3924
Website:
Map and Directions
Authorized official contact:
Name: Fitts, Tanya Jean Doctor of Medicine (MD)
Phone: (662) 236-3939

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 17111 Mississippi

Profile Details

NPI number 1144418609
LBN Legal business name Lafayette Pediatric Clinic
DBA Doing business as
Authorized official Fitts, Tanya Jean Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2007
Last updated Mar 17th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144418609 NPPES
Mississippi MEDICAID 00125498

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