Individual
DR. KENNETH RAY DAUGHTREY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 S HOLLY AVE, COLLINS, MS 39428-3894
(601) 765-6711
(601) 698-0186
Mailing address
PO BOX 55, SEMINARY, MS 39479-0055
(601) 506-7468
(601) 429-9403
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11516
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04475520
—
MS
Enumeration date
08/03/2006
Last updated
10/29/2024
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