Healthcare Provider Details

I. General information

NPI: 1336071497
Provider Name (Legal Business Name): GULF COAST ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2781 C T SWITZER SR DR STE 101
BILOXI MS
39531-4535
US

IV. Provider business mailing address

2781 C T SWITZER SR DR STE 101
BILOXI MS
39531-4535
US

V. Phone/Fax

Practice location:
  • Phone: 228-594-2900
  • Fax:
Mailing address:
  • Phone: 228-594-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. LEAH ETHRIDGE
Title or Position: MANAGER
Credential: MHA
Phone: 228-594-2900