Gulf Coast Plastic Surgery

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

12046 Issued in MS

Legal business name

GULF COAST PLASTIC SURGERY

Practice address

1133 45TH Ave
Gulfport, MS 39501-2564

Phone

(228) 865-7299

NPI assigned

Feb 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eric J Wyble

Title

Owner MD

Phone

(228) 865-7299

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1093780959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395020366",
            "telephone_number": "228-865-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 45TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012564",
            "telephone_number": "228-865-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "WYBLE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER  MD",
        "authorized_official_telephone_number": "228-865-7299",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "12046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG9511",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Neurospa LLC
• Gulf Coast Pediatric Care LLC
• Gulf Coast Pediatric Dentistry PLLC
• Gulf Coast Periodontics & Implants LLC
• Gulf Coast Physical Therapy Centers PA
• Gulf Coast Play Therapy Clinic, LLC
• Gulf Coast Psychotherapy
• Gulf Coast Recovery Clinic
• Gulf Coast Spinal & Neurosurgical Specialists
• Gulf Coast Spinal & Neurosurgical Specialists LLC

• Plastic Surgery Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Plastic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.