Individual
MICHAEL RYAN GARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4682
(601) 982-7850
(601) 366-8507
Mailing address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4682
(601) 982-7850
(601) 366-8507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-3339
MS
207RC0000X
Cardiovascular Disease Physician
Primary
27091
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08653039
—
MS
Enumeration date
04/04/2017
Last updated
11/09/2023
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