Healthcare Provider Details

I. General information

NPI: 1235049610
Provider Name (Legal Business Name): BILOXI FAMILY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LAMEUSE ST
BILOXI MS
39530-3107
US

IV. Provider business mailing address

201 LAMEUSE ST
BILOXI MS
39530-3107
US

V. Phone/Fax

Practice location:
  • Phone: 228-374-7888
  • Fax: 228-435-1545
Mailing address:
  • Phone: 228-374-7888
  • Fax: 228-435-1545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN W BARNES
Title or Position: OFFICE MANAGER
Credential:
Phone: 228-374-7888