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NPI Code Detail

MEDICARE: GULF COAST CHILDREN'S CLINIC

MEDICARE: GULF COAST CHILDREN'S CLINIC
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
1208000000XPediatrics Physician

Other Identifiers

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

General Provider Information

NPI Number : 1992154025
Entity Type Code : Organization
Provider Name (Legal Business Name) : GULF COAST CHILDREN'S CLINIC
Provider Business Mailing Address
First Line : 1720A MEDICAL PARK DR
Second Line : SUITE 200
City : BILOXI
State : MS
Zip : 39532-2129
Country : US
Telephone Number : 228-396-2726
Fax Number : 228-875-1009
Provider Business Practice Location Address
First Line : 3650 GROVELAND RD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5754
Country : US
Telephone Number : 228-875-0780
Fax Number : 228-875-1009
Authorized Official
Title or Position : ADMINISTRATOR
Name : MEICHELLE HARVEY
Credential :
Telephone Number : 228-875-0780
Provider Enumeration Date : 06/09/2016
Last Update Date : 06/09/2016

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Directions to “GULF COAST CHILDREN'S CLINIC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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