Provider Demographics
NPI:1437296183
Name:KERR, GARY II (REPT)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:KERR
Suffix:II
Gender:M
Credentials:REPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216 3RD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-2544
Mailing Address - Country:US
Mailing Address - Phone:228-697-9580
Mailing Address - Fax:
Practice Address - Street 1:10216 3RD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-2544
Practice Address - Country:US
Practice Address - Phone:228-697-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic