Dedri Markita Ivory in Vicksburg - Rheumatology
Dedri Markita Ivory - NPI 1851585004
Dedri Markita Ivory is a Rheumatology in Vicksburg, Mississippi. Dedri Markita Ivory practices all healthcare services and medical treatments related to Rheumatology. The NPI Number for Dedri Markita Ivory is 1851585004. The last update date is 2017-01-13.
Dedri Markita Ivory's current location address is 3510 Pemberton Square Blvd, Vicksburg, Mississippi. You can contact this provider via phone number 6015016991 and fax number 6015016987. The mailing address for Dedri Markita Ivory is 3510 Pemberton Square Blvd, Vicksburg, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dedri Markita Ivory |
|---|---|
| Address | 3510 Pemberton Square Blvd, Vicksburg, Mississippi |
| Phone Number | 6015016991 |
| Fax Number | 6015016987 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1851585004 |
|---|---|
| Provider Enumeration Date | 2007-08-30 |
| Last Updated Date | 2017-01-13 |
Provider Mailing Address Detail
| Address | 3510 Pemberton Square Blvd |
|---|---|
| City | Vicksburg |
| State | Mississippi (MS) |
| Post Code | 391805506 |
| Phone Number | 6015016991 |
| Fax Number | 6015016987 |
Provider's Primary Taxonomy Detail
| Speciality | Rheumatology |
|---|---|
| Taxonomy | 207Rr0500X |
| Licence No | 21520 |
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Definition: An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
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What is the Dedri Markita Ivory's unique identification number?
The Dedri Markita Ivory has been assigned the NPI (National Provider Identifier) Number 1851585004 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Dedri Markita Ivory's facilities are geographically located?
The facilities of Dedri Markita Ivory are physically situated at the following location: 3510 Pemberton Square Blvd, Vicksburg, MS, 391805506.
What is the Dedri Markita Ivory's area of specialization and corresponding taxonomy classification?
The Dedri Markita Ivory's specialty field is Rheumatology, and it falls under the taxonomy code 207Rr0500X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1851585004 to Dedri Markita Ivory?
The Centers for Medicare & Medicaid Services assigned the 1851585004 to Dedri Markita Ivory on 2007-08-30.
As of what date were the details related to Dedri Markita Ivory most recently updated or revised?
The information pertaining to Dedri Markita Ivory, including its address, specialty, and other relevant details, was last updated or revised on 2017-01-13.
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