HORN LAKE FAMILY PRACTICE INC – NPI #1508968421
Family Medicine

A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

HORN LAKE FAMILY PRACTICE INC is a provider located in HORN LAKE, MS. NPPES has assigned the NPI number 1508968421 to HORN LAKE FAMILY PRACTICE INC on September 01, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adolescent Medicine

The NPI profile was previously updated about 11 years ago on Jul 21, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HORN LAKE FAMILY PRACTICE INC below.

NPI Profile for
HORN LAKE FAMILY PRACTICE INC

NPI Number
1508968421
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HORN LAKE FAMILY PRACTICE INC
Primary location
3102 GOODMAN RD W
HORN LAKE, MS 38637-1172
Phone: (662) 342-6677 Fax: (662) 342-1213
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHEETAL SHARMA
OFFICE MANAGER
Phone: (662) 342-6677
Updated
Identifiers

Identifiers for HORN LAKE FAMILY PRACTICE INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS9015003
MEDICAIDMS00118511
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0000X
- Family Medicine / Adolescent Medicine (Primary)
MS 15476

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.