Prentiss Primary Care, P.a.

NPI #1902129455 in Prentiss, Mississippi

Provider Information

NPI Number: 1902129455
Entity Type: Organization
Organization Name: Prentiss Primary Care, P.a.
Primary Specialty: Internal Medicine
Enumeration Date: Mar 11, 2010
Last Updated: Mar 11, 2010

Practice Location

Address: 959 HWY 42
City: Prentiss
State: Mississippi
ZIP Code: 39474-1373
Phone: (601) 792-3200

Authorized Official

Name: DR. JAISHANKAR JAGADEESAN, MD
Title: PRESIDENT
Phone: (601) 792-3200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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