OrganizationActive
Ivancic Pediatric Clinic PA
NPI 1942606256 · Primary Care Clinic/Center · Tupelo, MS
Provider details
- NPI number
- 1942606256
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mitzi Parsons, Office Manager(662) 840-6026
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
499 Gloster Creek Vlg
Suite H-3
Tupelo, MS 38801-4600
Phone: (662) 840-6026
Fax: (662) 840-6030
Approximate (ZIP-level) locationGet directions
Mailing address
499 Gloster Creek Vlg
Tupelo, MS 38801-4600
Registry dates
- Enumerated
- 2014-11-13
- Last updated
- 2019-01-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.