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3920 Promenade Pkwy Suite A Diberville MS 39540-5368 | |
(228) 456-0173 | |
(228) 456-0174 |
Full Name | |
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Speciality | Family Medicine |
Location | 3920 Promenade Pkwy, Diberville, Mississippi |
Authorized Official Name and Position | Michael L Gingras (VICE PRESIDENT) |
Authorized Official Contact | 2395983131 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5811 Pelican Bay Blvd Suite 500 Naples FL 34108-2733 Ph: (239) 598-3131 | 3920 Promenade Pkwy Suite A Diberville MS 39540-5368 Ph: (228) 456-0173 |
NPI Number | 1518248319 |
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Provider Enumeration Date | 09/07/2011 |
Last Update Date | 11/29/2012 |
Identifier | Type | State | Issuer |
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1518248319 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Resolute Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4347 W Gay Rd, Diberville, MS 39540 Phone: 228-229-7989 | |
D'iberville Medical Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11516 Lamey Bridge Rd, Ste 1, Diberville, MS 39540 Phone: 228-207-4190 Fax: 228-207-4190 |