Basic Information
| Provider Information | |||||||||
| NPI: | 1922045475 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWEET | ||||||||
| FirstName: | SELIKA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 670 COUNTRY PLACE DR | ||||||||
| Address2: | |||||||||
| City: | PEARL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392086630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016642115 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1860 CHADWICK DR STE 351 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392043472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013761288 | ||||||||
| FaxNumber: | 6013762114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 14094 | MS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.