Desiree Buehler Pendergrass
M.D. | Pediatrics | Female
Desiree Buehler Pendergrass, M.D. is a Jackson, Mississippi based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Desiree Buehler Pendergrass is
2500 N State St, Jackson, Mississippi - 39216-4500. She can be contacted on phone at
601-815-8982.
Desiree Buehler Pendergrass is a sole proprietor of her business.
NPI number (Unique professional ID) for Desiree Buehler Pendergrass is
1255425989 which was assigned by NPPES on 03 Oct, 2006 and it was last updated on 17 Feb, 2017.
Desiree Buehler Pendergrass license number is
24712 for Pediatrics (208000000X) in Mississippi.
Desiree Buehler Pendergrass is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Desiree Buehler Pendergrass basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Desiree Buehler Pendergrass |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Desiree Buehler Pendergrass address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-815-8982 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1255425989 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 03 Oct, 2006 |
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| Last Updated On : | 17 Feb, 2017 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Desiree Buehler Pendergrass are as mentioned. Primary taxonomy code for Desiree Buehler Pendergrass, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | H4609 | TX |
| 208000000X | Pediatrics | Yes | 24712 | MS |
| 2083P0901X | Preventive Medicine Public Health & General Preventive Medicine | No | H4609 | TX |
| 2083P0901X | Preventive Medicine Public Health & General Preventive Medicine | No | 24712 | MS |
Legacy Identifiers:
Other legacy medical identifiers of Desiree Buehler Pendergrass such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 08907561 | Other | TX | NM MEDICAID |
| 132232307 | Other | TX | TMHP |
| 8J1510 | Other | TX | MEDICARE |
| 8G6058 | Other | TX | BC/BS |
| 155349101 | Other | TX | FIRSTCARE MEDICAID |
| 05359595 | MEDICAID | MS | |
| 200101350A | Other | TX | OK MEDICARE |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 2500 N State St
Jackson, MS, 39216-4500
United States |
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| Phone Number : | 601-815-8982 |
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Business Location:
Patients can refer following map for directions to
Desiree Buehler Pendergrass practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.