Provider Demographics
NPI:1043770845
Name:THOPPIL, MONIKA (MD)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:THOPPIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:KLEINKNECHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1203 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4354
Mailing Address - Country:US
Mailing Address - Phone:601-649-2863
Mailing Address - Fax:
Practice Address - Street 1:1203 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4354
Practice Address - Country:US
Practice Address - Phone:601-649-2863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS30553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program