Individual
LARRY W SIVILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
935 HIGHWAY 51, MADISON, MS 39110-8407
(601) 856-5986
(601) 853-2321
Mailing address
935 HIGHWAY 51, MADISON, MS 39110-8407
(601) 856-5986
(601) 853-2321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11084
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114414
—
MS
Enumeration date
08/05/2006
Last updated
07/08/2007
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