OrganizationActive
Physician Practice of Madison, PC
NPI 1114476389 · Specialist · Vicksburg, MS
Physician Practice of Madison, PC is a Specialist organization in Vicksburg, MS (NPI 1114476389).
Provider details
- NPI number
- 1114476389
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Shahjahan Sultan, Ceo(412) 721-2417
- License
- 21500 (MS)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1111 N Frontage Rd Fl 2
Vicksburg, MS 39180-5102
Phone: (412) 721-2417
Fax: (601) 510-2367
Street-level locationGet directions
Mailing address
6 Eastbrooke Cir
Madison, MS 39110-6537
Other names (DBA / former)
- Doing business as
- Physician Practice of Madison, PC
Registry dates
- Enumerated
- 2016-09-28
- Last updated
- 2016-09-28
Frequently asked questions
- What is Physician Practice of Madison, PC's NPI number?
- Physician Practice of Madison, PC's National Provider Identifier (NPI) is 1114476389, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Physician Practice of Madison, PC?
- Physician Practice of Madison, PC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Physician Practice of Madison, PC located?
- Physician Practice of Madison, PC's practice location on file with NPPES is 1111 N Frontage Rd Fl 2, Vicksburg, MS 39180-5102.
- What is Physician Practice of Madison, PC's phone number?
- The practice phone number listed in the NPPES registry for Physician Practice of Madison, PC is (412) 721-2417.
- Who is the authorized official for Physician Practice of Madison, PC?
- The authorized official listed on Physician Practice of Madison, PC's NPPES record is Shahjahan Sultan, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Physician Practice of Madison, PC's NPI active?
- Yes — Physician Practice of Madison, PC's NPI (1114476389) is active in the NPPES registry as of the last update on 2016-09-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.