PHYSICIAN PRACTICE OF MADISON, PC
NPI 1114476389
Specialist in Vicksburg, MS
- Organization
- Specialist
About PHYSICIAN PRACTICE OF MADISON, PC
This page provides the complete NPI Profile along with additional information for Physician Practice Of Madison, Pc, a provider established in Vicksburg, Mississippi operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1114476389 assigned on September 2016. The practitioner's primary taxonomy code is 174400000X with license number 21500 (MS). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Physician Practice Of Madison, Pc. The authorized official of this NPI record is Dr. Shahjahan Sultan M.d. (Ceo)
- NPI
- 1114476389 Verify this NPI
- Provider Legal Name
- PHYSICIAN PRACTICE OF MADISON, PC
- Other Organization Name
- PHYSICIAN PRACTICE OF MADISON, PC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1111 N FRONTAGE RD FL 2 VICKSBURG, MS 39180
- Location Phone
- (412) 721-2417
- Location Fax
- (601) 510-2367
- Mailing Address
- 6 EASTBROOKE CIR MADISON, MS 39110
- Mailing Phone
- (412) 721-2417
- Mailing Fax
- (601) 510-2367
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-28-2016
- Last Update Date
- 09-28-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 21500
- License State
- MS
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 351416 | OTHER (01) | MS | MEDICARE PTAN |
| 04377714 | MEDICAID (05) | MS |
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114476389, enumerated as an "organization" on September 28, 2016.
The provider is located at 1111 N FRONTAGE RD FL 2 VICKSBURG, MS 39180 and the phone number is (412) 721-2417.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
