Individual
DR. KENNETH E PERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2311 HIGHWAY 15 S, LOUISVILLE, MS 39339-7071
(662) 779-0119
Mailing address
2311 HIGHWAY 15 S, LOUISVILLE, MS 39339-7071
(662) 779-0119
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17518
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125174
—
MS
Enumeration date
11/13/2006
Last updated
07/08/2007
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