| |
15200 Community Rd Gulfport MS 39503-3085 | |
(228) 575-7112 | |
(228) 575-7190 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 15200 Community Rd, Gulfport, Mississippi |
Authorized Official Name and Position | Janet Williams (PROVIDER SERVICES SPECIALIST) |
Authorized Official Contact | 2284977576 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
2101 Highway 90 Gautier MS 39553-5340 Ph: (228) 497-7576 | 15200 Community Rd Gulfport MS 39503-3085 Ph: (228) 575-7112 |
NPI Number | 1487327193 |
---|---|
Provider Enumeration Date | 07/28/2021 |
Last Update Date | 08/26/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487327193 | NPI | - | NPPES |
09833721 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
314000000X | Skilled Nursing Facility | (* (Not Available)) | Secondary |
My Brother's Keeper, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Bridge St, Gulfport, MS 39507 Phone: 769-216-2455 | |
The Healing Hub Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 29th Ave Ste 26, Gulfport, MS 39501 Phone: 228-380-0662 | |
Children's International, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15465 Oak Ln, Gulfport, MS 39503 Phone: 228-831-8800 Fax: 228-831-8020 | |
Gulf Coast Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4540 W Railroad St, Gulfport, MS 39501 Phone: 228-867-6062 Fax: 228-867-2598 | |