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NPI Code Detail

MEDICARE: PATTON MEDICAL OF THE GULF COAST INC

MEDICARE: PATTON MEDICAL OF THE GULF COAST INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063440584
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATTON MEDICAL OF THE GULF COAST INC
Provider Business Mailing Address
First Line : 3002 BIENVILLE BLVD
Second Line : SUITE C
City : OCEAN SPRINGS
State : MS
Zip : 39564-4354
Country : US
Telephone Number : 228-872-8685
Fax Number : 228-872-8685
Provider Business Practice Location Address
First Line : 3002 BIENVILLE BLVD
Second Line : SUITE C
City : OCEAN SPRINGS
State : MS
Zip : 39564-4354
Country : US
Telephone Number : 228-872-8685
Fax Number : 228-872-8685
Authorized Official
Title or Position : OWNER
Name : MR. WILLIAM KEITH WADE
Credential :
Telephone Number : 228-872-8685
Provider Enumeration Date : 06/30/2006
Last Update Date : 04/05/2011

Similar Medicare Providers

1174521918 — PATTON MEDICAL OF THE GULF COAST, INC.
Practice Location Address:
3002 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-8685
Practice Fax:
1700177938 — SHANNON G DICKEY R.PH.
Practice Location Address:
3082 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-2646
Practice Fax:
1235400763 — DR. MELISSA WEBSTER PHARM.D.
Practice Location Address:
3082 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-2646
Practice Fax: 228-818-5632
1093129074 — CARESSA THORNTON
Practice Location Address:
3082 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-2646
Practice Fax: 228-818-5632
1265808570 — THUY-TIEN NGUYEN PHARM. D
Practice Location Address:
3082 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-2646
Practice Fax:
1083087449 — HUY HOANG
Practice Location Address:
3082 BIENVILLE BLVD
OCEAN SPRINGS, MS
39564-4354
Practice Phone: 228-872-2646
Practice Fax:

Directions to “PATTON MEDICAL OF THE GULF COAST INC ” Practice Location

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