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General NPI Number Information
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NPI Number | 1295918894
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Entity Type | Organization
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Legal Business Name | ENDOCRINE CARE CENTER, PLLC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 147 REYNOIR ST SUITE 305
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City | BILOXI
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State | MS
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Zip | 39530-4109
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Country | US
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Telephone | 228-432-5200
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Fax | 228-432-5201
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Provider Business Mailing Address
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Address Line | PO BOX 7029
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City | DIBERVILLE
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State | MS
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Zip | 39540-7001
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Country | US
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Telephone | 228-432-5200
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Fax | 228-432-5201
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD W. FRIEZE
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Credential | MD
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Telephone | 228-432-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 19154
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License Number State | MS
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