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General NPI Number Information
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NPI Number | 1306343173
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Entity Type | Organization
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Legal Business Name | DR. RAYMOND MONSOUR SCURFIELD, LLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 15465 OAK LANE STE 100-G
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City | GULFPORT
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State | MS
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Zip | 39503
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Country | US
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Telephone | 228-234-2062
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Fax |
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Provider Business Mailing Address
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Address Line | 15465 OAK LN STE 100-G
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City | GULFPORT
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State | MS
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Zip | 39503-2663
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Country | US
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Telephone | 228-234-2062
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | DR. RAYMOND SCURFIELD
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Credential |
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Telephone | 228-234-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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