Provider Demographics
NPI:1366544603
Name:KUMAR, PARVEEN (MD)
Entity type:Individual
Prefix:DR
First Name:PARVEEN
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2706
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-2706
Mailing Address - Country:US
Mailing Address - Phone:601-605-9914
Mailing Address - Fax:601-605-9904
Practice Address - Street 1:601 RENAISSANCE WAY
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6038
Practice Address - Country:US
Practice Address - Phone:601-605-9914
Practice Address - Fax:601-605-9904
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS152672084P0802X, 2084S0012X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118829Medicaid
MS00118829Medicaid
G88599Medicare UPIN