Provider Demographics
NPI:1851419667
Name:KAMLESH PAREKH
Entity Type:Organization
Organization Name:KAMLESH PAREKH
Other - Org Name:PAREKH MEDICAL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMLESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-562-8278
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-0247
Mailing Address - Country:US
Mailing Address - Phone:662-562-8278
Mailing Address - Fax:662-562-8279
Practice Address - Street 1:300 E MAIN STREET PLZ
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2227
Practice Address - Country:US
Practice Address - Phone:662-562-8278
Practice Address - Fax:662-562-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14012207R00000X
MSR842318363L00000X
MSR138480363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123998Medicaid
MS00124064Medicaid
MS00114201Medicaid
MS05985004Medicaid
MS500002208Medicare ID - Type UnspecifiedANITA GOLDEN MEDICARE
MSP28576Medicare UPIN
MS110000685Medicare ID - Type UnspecifiedDR PAREKH'S MEDICARE NUMB
MS00124064Medicaid
MS05985004Medicaid
MS500001517Medicare ID - Type UnspecifiedPATRICIA BLAIR MEDICARE
MS00114201Medicaid