Provider Demographics
NPI:1952399156
Name:PANDYA-LIPMAN, RASHMI K (MD)
Entity Type:Individual
Prefix:MRS
First Name:RASHMI
Middle Name:K
Last Name:PANDYA-LIPMAN
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:PO BOX 1329
Mailing Address - Street 2:3964 GOODMAN RD, STE 125
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-0013
Mailing Address - Country:US
Mailing Address - Phone:662-890-7361
Mailing Address - Fax:662-890-7369
Practice Address - Street 1:3964 GOODMAN RD E STE 125
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-6494
Practice Address - Country:US
Practice Address - Phone:662-890-7361
Practice Address - Fax:662-890-7369
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028647207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118627Medicaid
F82940Medicare UPIN