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General NPI Number Information
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NPI Number | 1578062725
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Entity Type | Organization
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Legal Business Name | GULF COAST SLEEP MEDICINE LLC
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 2112 BIENVILLE BLVD. SUITE P
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564
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Country | US
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Telephone | 228-334-5437
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Fax | 898-855-6495
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Provider Business Mailing Address
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Address Line | 2112 BIENVILLE BLVD. SUITE P
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564
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Country | US
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Telephone | 228-334-5437
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Fax | 898-855-5649
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL E DARIN
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Credential | M.D.
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Telephone | 228-281-0679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 22165
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 22165
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 22165
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License Number State | MS
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