DR. MANDAR R JAGTAP (NPI# 1255560918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255560918 |
| Entity Type | Individual |
| Full Name | DR. MANDAR R JAGTAP |
| Credential | D.O. |
| Practice Address |
611 Alcorn Dr Ste 230 Corinth MS 38834-9323 |
| Practice Telephone | 6622875218 |
| Practice Fax Number | 6622863186 |
| Mailing Telephone | 6622875218 |
| Mailing Fax Number | 6622863186 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2018-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
OS13840 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MS MEDICARE | 597760YLL0 | 01 |
| MS | 01857892 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1005 City Ave N, Ripley, MS 386631414 | 6622875218 | 6622863186 |
| 202 N 1st St, Booneville, MS 388292718 | 6622865218 | 6622863186 |
| 100 Hospital St, Booneville, MS 388293354 | 6622875218 | 6622863186 |
| 2001 W 68th St, Suite 202, Hialeah, FL 330161801 | 3053642107 |
| Street Address |
611 ALCORN DR STE 230 |
| City | CORINTH |
| State | MS |
| Zip Code | 38834-9323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255825113 | Amanda Mccalla | Nurse Practitioner | 611 Alcorn Dr Ste 230, Corinth, MS 38834-9323 | 2018-06-14 |
| 1356667455 | Kimberly Kuykendall Marlar | Nurse Practitioner | 611 Alcorn Dr Ste 230, Corinth, MS 38834-9323 | 2010-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176824 | Crystalcare | Clinic/Center | 3124 N Shiloh Road, Corinth, MS 38834 | 2020-05-20 |
| 1962046680 | Wanda Lee Kilpatrick | Technician | 1206 Breckenridge St., Corinth, MS 38834 | 2019-11-06 |
| 1215595756 | Alanna Nunez Heflin | Dentist | 3127 E Shiloh Rd, Corinth, MS 38834 | 2019-05-30 |
| 1629530795 | A Port In The Storm (apits) | Clinic/Center | 102 N. Cass Street, Suite B, Corinth, MS 38834 | 2019-04-05 |
| 1538654199 | Jerry Wayne Latch | Durable Medical Equipment & Medical Supplies | 206 N Fillmore St, Corinth, MS 38834 | 2018-06-26 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
| 1164938650 | Pediatric Dentistry of Corinth | Dentist | 1500 N Harper Rd #5, Pediatric Dentistry of Corinth, Corinth, MS 38834 | 2017-12-19 |
| 1467964536 | King Speech-language Therapy, LLC | Speech-Language Pathologist | 2203 Hwy 72 East, Corinth, MS 38834 | 2017-10-30 |
| 1841669728 | Glenda Gatlin | Social Worker | 14 Cr 305, Corinth, MS 38834 | 2015-09-21 |
| 1649646555 | Amanda Word | Social Worker | 303 North Madison Street, Corinth, MS 38834 | 2015-08-14 |
| Find all providers in zip 38834 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104434356 | Prime Heart and Vascular Care | Internal Medicine | 1310 Highway 72 E, Corinth, MS 38834-6524 | 2020-07-14 |
| 1962423897 | Morgan Cardiovascular, PC | Internal Medicine | 2427 Proper St, Corinth, MS 38834-5394 | 2006-07-23 |
| 1699708008 | Emad Hashim Mohamed | Internal Medicine | 3196 Highway 72 W, Corinth, MS 38834-9303 | 2006-07-09 |
| 1265062434 | Prime Cardiovascular, LLC | Internal Medicine | 3196 Highway 72 W, Corinth, MS 38834-9303 | 2020-01-16 |
| 1508133380 | Magnolia Cardiology Associates | Internal Medicine | 611 Alcorn Dr, 230, Corinth, MS 38834-9323 | 2011-11-22 |
| 1922262104 | Nanni Pidikiti Md PC | Internal Medicine | 703 Alcorn Dr, Suite 104, Corinth, MS 38834-9302 | 2008-07-16 |
| 1780865725 | Corinth Cardiology Pllc | Internal Medicine | 3196 Highway 72 W, Corinth, MS 38834-9303 | 2007-11-19 |
| 1902820350 | John W. Prather, M.d. | Internal Medicine | 703 Alcorn Dr, Suite 102, Corinth, MS 38834-9302 | 2006-07-27 |
| 1043233372 | John Wayne Prather | Internal Medicine | 611 Alcorn Dr, Suite 230, Corinth, MS 38834-9321 | 2006-07-26 |
| 1194749150 | Kerry Dean Morgan | Internal Medicine | 2427 Proper St, Corinth, MS 38834-5394 | 2006-07-26 |
| Find all providers in CORINTH | ||||
Please comment or provide details below to improve the information on DR. MANDAR R JAGTAP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.