Provider Demographics
NPI:1922045475
Name:SWEET, SELIKA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SELIKA
Middle Name:M
Last Name:SWEET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:670 COUNTRY PLACE DR
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-6630
Mailing Address - Country:US
Mailing Address - Phone:601-664-2115
Mailing Address - Fax:
Practice Address - Street 1:1860 CHADWICK DR STE 351
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-3472
Practice Address - Country:US
Practice Address - Phone:601-376-1288
Practice Address - Fax:601-376-2114
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14094207Q00000X
IL036153853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F59074Medicare UPIN