Organization
RIVER CITY MEDICAL AND ARTHRITIS CENTER LLC
Active
Organization
RIVER CITY MEDICAL AND ARTHRITIS CENTER LLC
Active
Other names
Dedri M Ivory MD PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEDRI M IVORY MD (OWNER)
(601) 501-6991
Entity
Organization
Contact information
Practice address
3510 PEMBERTON SQUARE BLVD, VICKSBURG, MS 39180-5506
(601) 501-6991
(601) 501-6987
Mailing address
3510 PEMBERTON SQUARE BLVD, VICKSBURG, MS 39180-5506
(601) 501-6991
(601) 501-6987
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
21520
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08551324
—
MS
Enumeration date
03/30/2016
Last updated
01/13/2017
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