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Contact Information

LAFAYETTE PEDIATRIC CLINIC
2166 S LAMAR BLVD
OXFORD, MS38655-5224
 Phone: 662-236-3939
 Fax: 662-236-3924
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for LAFAYETTE PEDIATRIC CLINIC

NPI Number 1144418609
LBN Legal business name LAFAYETTE PEDIATRIC CLINIC
Authorized official TANYA FITTS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2007
Last updated 03/17/2010 - About 16 years ago
Identifiers
MS License # 17111
MS Medicaid 00125498
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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