Provider Demographics
NPI:1962898015
Name:ALVAREZ, KRISTIE (MD)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 FLOWOOD DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9019
Mailing Address - Country:US
Mailing Address - Phone:601-815-5700
Mailing Address - Fax:601-815-5795
Practice Address - Street 1:2466 FLOWOOD DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9019
Practice Address - Country:US
Practice Address - Phone:601-815-5700
Practice Address - Fax:601-815-5795
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS00000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine