Healthcare Provider Details

I. General information

NPI: 1184941676
Provider Name (Legal Business Name): ONCALL MEDICAL CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3091 BIENVILLE BLVD
OCEAN SPRINGS MS
39564-4308
US

IV. Provider business mailing address

3091 BIENVILLE BLVD
OCEAN SPRINGS MS
39564-4308
US

V. Phone/Fax

Practice location:
  • Phone: 228-818-5155
  • Fax: 228-818-5159
Mailing address:
  • Phone: 228-818-5155
  • Fax: 228-818-5159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11483
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD FLOYD ALDRIDGE III
Title or Position: OWNER
Credential:
Phone: 228-818-5155