Provider Demographics
NPI:1811918246
Name:CATHEY, GENE DAVID (MD)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:DAVID
Last Name:CATHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SIMPSON HIGHWAY 149
Mailing Address - Street 2:SUITE 360
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-3841
Mailing Address - Country:US
Mailing Address - Phone:601-849-1245
Mailing Address - Fax:
Practice Address - Street 1:360 SIMPSON HIGHWAY 149
Practice Address - Street 2:SUITE 360
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3841
Practice Address - Country:US
Practice Address - Phone:601-849-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03852767Medicaid
MS03852767Medicaid
MS080004269Medicare ID - Type Unspecified