Kids Klinic LLC
Organization Active NPI Rural Health Clinic/Center · Carriere, MS
NPI 1215277652 · NPPES record last updated Dec 3, 2015
Key facts
- NPI
- 1215277652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 13678 (MS)
- Legal business name
- KIDS KLINIC LLC
- Practice address
- 200 Country Club Rd
Carriere, MS 39426-9037 - Phone
- (601) 799-4777
- NPI assigned
- Feb 21, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Ahmad Haidar, MD
- Title
- Owner
- Phone
- (601) 799-4777
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 13678 | MS | Yes |
Addresses
Primary practice location
200 Country Club Rd
Carriere, MS 39426-9037
Mailing address
200 Country Club Rd
Carriere, MS 39426-9037
Phone (601) 799-4777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00112453 | Medicaid | MS |
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All providers in Carriere, MS · Rural Health Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.