Bay Plaza Medical Clinic | |
618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 | |
(228) 463-0824 | |
(228) 463-0827 |
Full Name | Bay Plaza Medical Clinic |
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Speciality | Pediatrics |
Location | 618 Blue Meadow Rd, Bay St Louis, Mississippi |
Authorized Official Name and Position | Randy Robinson (ADMINISTRATOR) |
Authorized Official Contact | 2288651453 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bay Plaza Medical Clinic 1612 31st Ave Gulfport MS 39501-2750 Ph: (228) 865-1453 | Bay Plaza Medical Clinic 618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 Ph: (228) 463-0824 |
NPI Number | 1477599280 |
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Provider Enumeration Date | 06/21/2006 |
Last Update Date | 05/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477599280 | NPI | - | NPPES |
02976571 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
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