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NPI Code Detail

MEDICARE: HOGAN SURGICAL CENTER PA

MEDICARE: HOGAN SURGICAL CENTER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center25C0001038MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104829597
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOGAN SURGICAL CENTER PA
Provider Business Mailing Address
First Line : 351 COWAN RD
Second Line :
City : GULFPORT
State : MS
Zip : 39507-2019
Country : US
Telephone Number : 228-896-1120
Fax Number : 228-896-1332
Provider Business Practice Location Address
First Line : 351 COWAN RD
Second Line :
City : GULFPORT
State : MS
Zip : 39507-2019
Country : US
Telephone Number : 228-896-1120
Fax Number : 228-896-1332
Authorized Official
Title or Position : OWNER
Name : DR. KIPER C NELSON
Credential : MD
Telephone Number : 228-896-1120
Provider Enumeration Date : 05/31/2005
Last Update Date : 02/20/2025

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Directions to “HOGAN SURGICAL CENTER PA ” Practice Location

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