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General NPI Number Information
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NPI Number | 1861703720
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Entity Type | Organization
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Legal Business Name | HORRELL TOWNSEND, DO, PLLC
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 11010 DAVID ST UNIT B
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City | GULFPORT
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State | MS
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Zip | 39503-3481
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Country | US
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Telephone | 228-832-7799
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Fax | 228-832-7769
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Provider Business Mailing Address
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Address Line | 11010 DAVID ST UNIT B
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City | GULFPORT
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State | MS
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Zip | 39503-3481
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Country | US
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Telephone | 228-832-7799
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Fax | 228-832-7769
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HORRELL H TOWNSEND
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Credential | DO
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Telephone | 228-832-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 11143
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License Number State | MS
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