DESOTO CHILDREN'S CLINIC - OLIVE BRANCH


Address: 7145 Goodman Road, Olive Branch, MS 38654
Phone: 6623335001

DESOTO CHILDREN'S CLINIC - OLIVE BRANCH (NPI# 1891179768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891179768
Entity Type Organization
Organization Name DESOTO CHILDREN'S CLINIC - OLIVE BRANCH
Practice Address 7145 Goodman Road
Olive Branch
MS 38654
Practice Telephone 6623335001
Practice Fax Number 6624207063
Mailing Telephone 6623335001
Mailing Fax Number 6624207063
Enumeration Date 2015-07-10
Last Update Date 2018-09-11
Authorized Official Name MR. DESH DEEPAK SIDHU (MD)
Authorized Official Telephone 6625624418
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics MS Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS 00016777 05
MS 07529722 05

Office Location

Street Address 7145 GOODMAN ROAD
City OLIVE BRANCH
State MS
Zip Code 38654

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093366213 Latonya Shontae Binion Home Health 5915 Brice Cove North, Olive Branch, MS 38654 2019-09-28
1356828677 Heath Bryan Coleman, Dds of Mississippi II, Pllc Dentist 688 Goodman Rd, Ste 123, Olive Branch, MS 38654 2018-07-20
1629565684 Alexis Summerville Mcdavis Pharmacist 7950 Craft Goodman Frontage Rd, Olive Branch, MS 38654 2018-04-16
1194237206 Exos Physical Therapy and Sports Medicine, LLC Physical Therapist 6542 Goodman Rd, Olive Branch, MS 38654 2017-10-30
1609386515 Laken Hood Richardson Physical Therapist 9085 East Sandidge Cove, Suite 250, Olive Branch, MS 38654 2017-10-05
1275064255 Heart of Hospice, LLC Hospice Care, Community Based 9849 Highway 178 Unit B, Olive Branch, MS 38654 2017-03-22
1023557865 Michael Patrick Mccallum Counselor 9320 Railroad Ave., Olive Branch, MS 38654 2017-02-13
1891185203 Kristina Harper Midwife 9086 Pigeon Roost Rd Ste C, Olive Branch, MS 38654 2015-01-23
1275955098 Global Medical Durable Medical Equipment & Medical Supplies 6229 Hwy 305 Ste L, Olivebranch, MS 38654 2014-01-14
1649612680 Olive Branch Urgent Care #1 LLC Clinic/Center 5142 Goodman Road, Suite 107, Olive Branch, MS 38654 2013-07-18
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Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649450909 Memphis Children's Clinic,pllc Pediatrics 9860 Goodman Rd, Olive Branch, MS 38654-1722 2007-11-05
1124329016 Vani Kudlur Chandrappa Pediatrics 5480 Goodman Rd, Olive Branch, MS 38654-7902 2010-11-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1508464181 Meredith Sanford Pediatrics 101 Farm View Dr, Oxford, MS 38655-7728 2020-10-15
1255947297 Gluckstadt Tc Kids, LLC Pediatrics 101 Lexington Dr Ste A, Madison, MS 39110-6986 2020-09-16
1982224895 Vpa PC Pediatrics 111 E Capitol St Ste 215, Jackson, MS 39201-2108 2020-04-21
1992356166 Marcie P Errington Pediatrics 3110 Sumrall Rd, Crystal Springs, MS 39059-8955 2019-09-27
1235635566 North Mississippi Medcial Center, Inc. Pediatrics 1150 S Green St Ste D, Tupelo, MS 38804-4901 2018-04-04
1538675798 The Pedz Clinic Pediatrics 610 3rd St Sw, Magee, MS 39111-3994 2017-12-22
1841715539 Happicare One LLC Ppec Pediatric Daycare Pediatrics 213 W Park Ave, Greenwood, MS 38930-3008 2017-08-03
1336598028 Andrea Logan Md Pediatrics 3631 Bienville Blvd Ste B, Ocean Springs, MS 39564-5702 2016-06-03
1730541640 Stephanie Harrell Pediatrics 309 Llewellyn Ave, Mccomb, MS 39648-2703 2016-03-22
1093109316 Justin M. Lay Pediatrics 7726 Old Canton Road, Madison, MS 39110 2015-03-25
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City OLIVE BRANCH
Zip Code 38654

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Dataset Information

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.

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