| Gulf Coast Life, Pllc | |
|
4405 E Aloha Dr Diamondhead MS 39525-3380 | |
| (228) 255-8818 | |
| (228) 255-8820 |
| Full Name | Gulf Coast Life, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4405 E Aloha Dr, Diamondhead, Mississippi |
| Authorized Official Name and Position | Erin Adam Dewitt (PHYSICIAN) |
| Authorized Official Contact | 2282558818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Life, Pllc 4405 E Aloha Dr Diamondhead MS 39525-3380 Ph: (228) 255-8818 | Gulf Coast Life, Pllc 4405 E Aloha Dr Diamondhead MS 39525-3380 Ph: (228) 255-8818 |
| NPI Number | 1700264025 |
|---|---|
| Provider Enumeration Date | 05/07/2015 |
| Last Update Date | 05/07/2015 |
| Medicare PECOS PAC ID | 0042531147 |
|---|---|
| Medicare Enrollment ID | O20150601002611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700264025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Erin A Dewitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508942137 PECOS PAC ID: 0345240800 Enrollment ID: I20070105000426 |
| Provider Name | Tara L Sykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033437587 PECOS PAC ID: 5991963787 Enrollment ID: I20120224000606 |
Ochsner Health Center - Shepherd Square Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4550 Shepherd Sq, Diamondhead, MS 39525 Phone: 228-255-8216 | |
Hancock Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5400 Indian Hill Blvd, Diamondhead, MS 39525 Phone: 228-586-9229 Fax: 228-586-9230 | |
Ochsner Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4402 E Aloha Dr Ste 16, Diamondhead, MS 39525 Phone: 228-364-9001 Fax: 228-364-9004 | |
Memorial Hospital At Gulfport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4300 Leisure Time Dr, Suite A, Diamondhead, MS 39525 Phone: 228-255-4300 Fax: 228-255-3626 | |
Ochsner Health Center - Diamond Head Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4540 Shepherd Sq, Diamondhead, MS 39525 Phone: 228-255-8216 | |
Hancock Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4433 Leisure Time Dr., Diamondhead, MS 39525 Phone: 228-586-9229 Fax: 228-586-9230 |