Provider Demographics
NPI:1730341280
Name:RONNYE D PURVIS M.D. PC
Entity type:Organization
Organization Name:RONNYE D PURVIS M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNYE
Authorized Official - Middle Name:
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-485-8975
Mailing Address - Street 1:2420 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-5033
Mailing Address - Country:US
Mailing Address - Phone:601-485-8975
Mailing Address - Fax:601-483-6129
Practice Address - Street 1:2420 11TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-5033
Practice Address - Country:US
Practice Address - Phone:601-485-8975
Practice Address - Fax:601-483-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS393605196COtherBC MS
MS00118517Medicaid
MS393605196COtherBC MS
MS160000361Medicare PIN