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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00112453MedicaidMS

Other providers in Carriere, MS

All providers in Carriere, MS · Rural Health Clinic/Center in Mississippi

Sources for this page

Verify at the official NPI Registry.