Provider Demographics
NPI:1508253188
Name:TIO, MARIA CLARISSA ONG (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA CLARISSA
Middle Name:ONG
Last Name:TIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:504 CLINTON CENTER DR STE 4300
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5610
Mailing Address - Country:US
Mailing Address - Phone:601-496-9524
Mailing Address - Fax:043-460-1815
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-815-4775
Practice Address - Fax:601-815-4775
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2022-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS28495207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine