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General NPI Number Information
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NPI Number | 1588535025
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Entity Type | Organization
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Legal Business Name | OBTELECARE MISSISSIPPI, PC
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 4500 13TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-2515
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Country | US
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Telephone | 864-908-3530
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Fax |
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Provider Business Mailing Address
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Address Line | 777 LOWNDES HILL RD BLDG 1
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City | GREENVILLE
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State | SC
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Zip | 29607-2101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DENISE BURNS
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Credential |
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Telephone | 864-908-3530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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