Individual
DR. CRYSTAL N IBETOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
905C S FRONTAGE RD, MERIDIAN, MS 39301-6113
(601) 484-2793
Mailing address
905C S FRONTAGE RD, MERIDIAN, MS 39301-6113
(601) 484-2793
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
T4956
MS
207R00000X
Internal Medicine Physician
P114801
NY
Other
Enumeration date
07/13/2022
Last updated
07/05/2023
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