Bray, Gina Vick
Bray, Gina Vick is an sole proprietor health care provider with primary practice located at 187 Stateline Rd E Suite 10, Southaven MS 38671-1704. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Bray, Gina Vick can be contacted via phone (662) 342-5353.Contact Information
Primary practice address
187 Stateline Rd E Suite 10
Southaven MS 38671-1704
Phone: (662) 342-5353
Fax: (662) 393-9753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15380 | Mississippi |
Profile Details
| NPI number | 1255338984 |
|---|---|
| LBN Legal business name | Bray, Gina Vick |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Apr 14th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255338984 | NPPES |
| Mississippi | MEDICAID | 0118418 |
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