Daughtrey, Kenneth Ray
Daughtrey, Kenneth Ray is an individual health care provider with primary practice located at 3550 Highway 468 W , Pearl MS 39208-5529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Daughtrey, Kenneth Ray can be contacted via phone (601) 351-8000.Contact Information
Primary practice address
3550 Highway 468 W
Pearl MS 39208-5529
Phone: (601) 351-8000
Fax: (601) 351-8301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 11516 | Mississippi |
Profile Details
| NPI number | 1902814361 |
|---|---|
| LBN Legal business name | Daughtrey, Kenneth Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Dec 8th, 2010 - about 15 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 | 1902814361 | NPPES |
| Mississippi | MEDICAID | 04475520 |
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