Individual
MILAN EDWARD IVANCIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
499 GLOSTER CREEK VLG, SUITE H-3, TUPELO, MS 38801-4600
(662) 840-6026
(662) 840-6030
Mailing address
499 GLOSTER CREEK VLG, SUITE H-3, TUPELO, MS 38801-4600
(662) 840-6026
(662) 840-6030
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
08988
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111471
—
MS
Enumeration date
07/15/2006
Last updated
01/17/2023
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