Ivory, Dedri Markita

Ivory, Dedri Markita is an individual health care provider with primary practice located at 3510 Pemberton Square Blvd , Vicksburg MS 39180-5506. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Rheumatology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Rheumatology is her primary health care specialty. Ivory, Dedri Markita can be contacted via phone (601) 501-6991.

Contact Information

Primary practice address
3510 Pemberton Square Blvd Vicksburg MS 39180-5506
Phone: (601) 501-6991
Fax: (601) 501-6987
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 21520 Mississippi
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 2009009253 Missouri
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 57.011968 Ohio

Profile Details

NPI number 1851585004
LBN Legal business name Ivory, Dedri Markita
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2007
Last updated Jan 13th, 2017 - about 9 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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