Provider Demographics
NPI:1033824297
Name:PONDER, SYDNEY MCCARY
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:MCCARY
Last Name:PONDER
Suffix:
Gender:F
Credentials:
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Mailing Address - Street 1:350 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2177
Mailing Address - Country:US
Mailing Address - Phone:901-226-4003
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:401 BAPTIST DR STE 301
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-2012
Practice Address - Country:US
Practice Address - Phone:601-973-1571
Practice Address - Fax:601-973-1577
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2025-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS905764363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine