Individual
DR. RICHARD K. IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1002 JEFFERSON ST, SUITE400, LAUREL, MS 39440-4306
(601) 649-7802
(601) 428-7841
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 399-6167
(601) 399-6262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12509
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114933
—
MS
Enumeration date
07/17/2006
Last updated
01/08/2020
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