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NPI Code Detail

MEDICARE: PATTON MEDICAL OF THE GULF COAST, INC.

MEDICARE: PATTON MEDICAL OF THE GULF COAST, INC.
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
1332B00000XDurable Medical Equipment & Medical SuppliesMS

General Provider Information

NPI Number : 1174521918
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATTON MEDICAL OF THE GULF COAST, INC.
Provider Business Mailing Address
First Line : 3002 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-4354
Country : US
Telephone Number : 228-872-8685
Fax Number :
Provider Business Practice Location Address
First Line : 3002 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-4354
Country : US
Telephone Number : 228-872-8685
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. WILLIAM KEITH WADE
Credential :
Telephone Number : 228-872-8685
Provider Enumeration Date : 07/13/2005
Last Update Date : 08/22/2020

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Directions to “PATTON MEDICAL OF THE GULF COAST, INC. ” Practice Location

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