Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT6567 | MS |
NPI | 1043841067 |
---|---|
Provider Name | Dr. Anthony Louis Oliveri |
First Address | Cleveland, MS 38732-2929 |
Second Address | Mound Bayou, MS 38762-9314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2020 |
Last Update Date | 29/01/2020 |