Provider Demographics
NPI:1891992061
Name:CASE, RYAN COREY (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:COREY
Last Name:CASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:201 S RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-3331
Mailing Address - Country:US
Mailing Address - Phone:601-835-0077
Mailing Address - Fax:601-835-0095
Practice Address - Street 1:201 S RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-3331
Practice Address - Country:US
Practice Address - Phone:601-835-0077
Practice Address - Fax:601-835-0095
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST1981207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology