Provider Demographics
NPI:1487747234
Name:RHEUMATOLOGY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRUPA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHANDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-360-1106
Mailing Address - Street 1:1190 N STATE ST STE 303
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2413
Mailing Address - Country:US
Mailing Address - Phone:601-360-1106
Mailing Address - Fax:601-360-1713
Practice Address - Street 1:1190 N STATE ST STE 303
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2413
Practice Address - Country:US
Practice Address - Phone:601-360-1106
Practice Address - Fax:601-360-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01976019Medicaid
MS01976019Medicaid