Gaddy, Ira Eugene

Gaddy, Ira Eugene is an sole proprietor health care provider with primary practice located at 10051 Lorraine Road Suite A, Gulfport MS 39503-6001. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Gaddy, Ira Eugene can be contacted via phone (228) 539-7762.

Contact Information

Primary practice address
10051 Lorraine Road Suite A Gulfport MS 39503-6001
Phone: (228) 539-7762
Fax: (228) 539-4953
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 08343 Mississippi
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 08343 Mississippi

Profile Details

NPI number 1730298506
LBN Legal business name Gaddy, Ira Eugene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2006
Last updated Aug 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730298506 NPPES
Mississippi MEDICAID 06303560
Mississippi MEDICAID 00013310

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