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General NPI Number Information
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NPI Number | 1346326808
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Entity Type | Organization
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Legal Business Name | FOOT SPECIALISTS OF SOUTH MISSISSIPPI PLLC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 999 N HALSTEAD RD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3105
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Country | US
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Telephone | 228-818-2801
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Fax | 228-818-2803
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Provider Business Mailing Address
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Address Line | PO BOX 6278
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City | DIBERVILLE
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State | MS
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Zip | 39540-6278
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Country | US
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Telephone | 228-818-2801
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Fax | 228-818-2803
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KIMBERLY GIBBS
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Credential |
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Telephone | 228-818-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 80130
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 80130
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | MS
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