Individual
DR. TIMOTHY R IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11700 HIGHWAY 57, VANCLEAVE, MS 39565-8309
(228) 826-1482
(228) 826-5924
Mailing address
11700 HIGHWAY 57, VANCLEAVE, MS 39565-8309
(228) 826-1482
(228) 826-5924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13532
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115653
—
MS
Enumeration date
06/21/2005
Last updated
12/29/2015
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