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General NPI Number Information
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NPI Number | 1982908877
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Entity Type | Organization
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Legal Business Name | PETAL URGENT CARE LLC
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1272 EVELYN GANDY PKWY STE 60
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City | PETAL
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State | MS
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Zip | 39465-3953
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Country | US
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Telephone | 707-319-5068
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Fax | 601-602-4681
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Provider Business Mailing Address
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Address Line | PO BOX 1248
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City | OCEAN SPRINGS
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State | MS
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Zip | 39566-1248
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Country | US
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Telephone | 601-336-5393
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Fax | 601-602-4681
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Authorized Official
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Title or Position | COO/PRESIDENT
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Name | BRIANNE NICHOLE WHITNEY
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Credential |
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Telephone | 707-319-5068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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