Monico, Carla G

Monico, Carla G is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Monico, Carla G can be contacted via phone (601) 984-5970.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-5970
Fax: (601) 984-5902
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 38268 Minnesota

Profile Details

NPI number 1437123825
LBN Legal business name Monico, Carla G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jan 6th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437123825 NPPES
Wisconsin MEDICAID 35334600
Wisconsin MEDICAID 525013700
Wisconsin MEDICAID 02623513
Wisconsin Other P01436115
Wisconsin Other 110129725
Wisconsin MEDICAID ENROLLED

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