Provider Demographics
NPI:1053428060
Name:METIN, NURAY (MD)
Entity type:Individual
Prefix:DR
First Name:NURAY
Middle Name:
Last Name:METIN
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 1:104 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668
Mailing Address - Country:US
Mailing Address - Phone:662-562-4418
Mailing Address - Fax:662-562-9024
Practice Address - Street 1:7676 SOUTHCREST PKWY
Practice Address - Street 2:
Practice Address - City:SOUTHHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671
Practice Address - Country:US
Practice Address - Phone:667-349-6577
Practice Address - Fax:662-349-6562
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14759208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00116251Medicaid
MS00116251Medicaid