Individual
DR. ANDREW LAURENCE RIVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 STATE STREET, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS 39216
(601) 984-1000
Mailing address
2500 NORTH STATE STREET, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21193
MS
2085R0202X
Diagnostic Radiology Physician
45475
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01167582
RAILROAD MEDICARE
MS
Enumeration date
03/28/2006
Last updated
03/11/2014
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