Desoto Children'S Clinic - Olive Branch

LBN: Desoto Children'S Clinic - Olive Branch
Desoto Children'S Clinic - Olive Branch is an health care organization with primary practice located at 7145 Goodman Road , Olive Branch MS 38654. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Desoto Children'S Clinic - Olive Branch can be contacted via phone (662) 333-5001, or through Sidhu, Desh Deepak via phone (662) 562-4418.

Contact Information

Primary practice address
7145 Goodman Road Olive Branch MS 38654
Phone: (662) 333-5001
Fax: (662) 420-7063
Website:
Map and Directions
Authorized official contact:
Name: Sidhu, Desh Deepak Doctor of Medicine (MD)
Phone: (662) 562-4418

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Mississippi

Profile Details

NPI number 1891179768
LBN Legal business name Desoto Children'S Clinic - Olive Branch
DBA Doing business as
Authorized official Sidhu, Desh Deepak Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2015
Last updated May 2nd, 2023 - about 2 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 1891179768 NPPES
Mississippi MEDICAID 00016777
Mississippi MEDICAID 07529722

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