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

Ajay Vongala, MD

Individual provider Family Medicine Physician · NPI 1194089508

Ajay Vongala, MD is a Family Practice in Jackson, Mississippi. Qualified in 2005, 21 years ago. Practices with Minor Med Care, LLC, a 81-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
21
Licensed in
MS
In the registry since
2012
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1225 N State St
Jackson, MS 39202-2064
Phone: (601) 968-1000
Fax: (601) 974-6241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 971 Lakeland Dr Ste 356, Jackson, MS 39216-4607 — (601) 200-4644

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 23970 (MS)

Record details

NPI number1194089508
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 29, 2012
Last updated in NPPESDecember 22, 2022
Certification dateDecember 22, 2022
Mailing address1225 N State St, Jackson, MS 39202-2064

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Minor Med Care, Llc — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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