Provider Demographics
NPI:1417975731
Name:ARMSTRONG, RALPH CRISS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:CRISS
Last Name:ARMSTRONG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 SUNSET DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-4086
Mailing Address - Country:US
Mailing Address - Phone:662-226-5747
Mailing Address - Fax:662-226-5622
Practice Address - Street 1:1300 SUNSET DR
Practice Address - Street 2:SUITE F
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4086
Practice Address - Country:US
Practice Address - Phone:662-226-5747
Practice Address - Fax:662-226-5622
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-06-28
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Provider Licenses
StateLicense IDTaxonomies
MS12471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSCH9466OtherRAILROAD MEDICARE
MS640835695OtherBC/BS OF MISSISSIPPI
MS0112659Medicaid
MS1700994738OtherPECOS
MS080170280OtherRAILROAD MEDICARE
MS09013778Medicaid
MS09014826Medicaid
MS0112659Medicaid
MS080170280OtherRAILROAD MEDICARE
MS1700994738OtherPECOS