Individual
RAVEN SUZANNE LADNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7275 S SIWELL RD, BYRAM, MS 39272-9767
(601) 373-7722
(601) 373-7378
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23900
MS
Other
Enumeration date
05/11/2012
Last updated
01/08/2020
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