Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prentiss Primary Care, PA

Organization Internal Medicine Physician · NPI 1902129455

Prentiss Primary Care, PA is an Internal Medicine Physician in Prentiss, Mississippi. Licensed in Mississippi. Registered with an NPI since 2010.

Licensed in
MS
In the registry since
2010
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

959 Hwy 42
Prentiss, MS 39474-1373
Phone: (601) 792-3200
Fax: (601) 792-3299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 15442 (MS)

Record details

NPI number1902129455
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jaishankar Jagadeesan — President · (601) 792-3200
NPI enumeratedMarch 11, 2010
Last updated in NPPESMarch 11, 2010
Mailing addressPo Box 1373, Prentiss, MS 39474-1373

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