Ivancic, Milan Edward

Ivancic, Milan Edward is an individual health care provider with primary practice located at 499 Gloster Creek Vlg Suite H-3, Tupelo MS 38801-4600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ivancic, Milan Edward can be contacted via phone (662) 840-6026.

Contact Information

Primary practice address
499 Gloster Creek Vlg Suite H-3 Tupelo MS 38801-4600
Fax: (662) 840-6030
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 08988 Mississippi

Profile Details

NPI number 1023034477
LBN Legal business name Ivancic, Milan Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated Jan 17th, 2023 - about 2 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 1023034477 NPPES
Mississippi MEDICAID 00111471

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