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General NPI Number Information
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NPI Number | 1306364435
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Entity Type | Organization
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Legal Business Name | OCEAN SPRINGS LUNG CLINIC LLC
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Dates
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Enumeration Date | 09/09/2017
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 2113 GOVERNMENT ST STE K2
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3949
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Country | US
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Telephone | 228-254-1366
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Fax | 228-254-1367
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Provider Business Mailing Address
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Address Line | 2113 GOVERNMENT ST STE K2
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3949
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Country | US
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Telephone | 228-254-1366
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Fax | 228-254-1367
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. SHAWN KEITH FRENCH
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Credential | DO
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Telephone | 228-254-1366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 22738
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License Number State | MS
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