Dedri Markita Ivory in Vicksburg - Student In An Organized Health Care Education/training Program
Dedri Markita Ivory - NPI 1851585004
Dedri Markita Ivory is a Student In An Organized Health Care Education/training Program in Vicksburg, Mississippi. Dedri Markita Ivory practices all healthcare services and medical treatments related to Student In An Organized Health Care Education/training Program. 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 |
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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 |
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Provider Enumeration Date | 2007-08-30 |
Last Updated Date | 2017-01-13 |
Provider Mailing Address Detail
Address | 3510 Pemberton Square Blvd |
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City | Vicksburg |
State | Mississippi (MS) |
Post Code | 391805506 |
Phone Number | 6015016991 |
Fax Number | 6015016987 |
Provider's Primary Taxonomy Detail
Speciality | Student In An Organized Health Care Education/training Program |
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Taxonomy | 390200000X |
Licence No | 2009009253 |
Definition: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Post Comment/ Review Below
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 Student In An Organized Health Care Education/training Program, and it falls under the taxonomy code 390200000X, 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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