Provider Demographics
NPI:1073928941
Name:AMOLENDA, PATRICIA GARCIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GARCIA
Last Name:AMOLENDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N. STATE ST.
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-984-5900
Mailing Address - Fax:601-984-5915
Practice Address - Street 1:2500 N. STATE ST.
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-984-5900
Practice Address - Fax:601-984-5915
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS923-L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology