Organization Active NPI

Spinal & Neurological Surgery of South Mississippi PLLC

  • Specialist
  • Gulfport, MS
National Provider Identifier
1174614325
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SPINAL & NEUROLOGICAL SURGERY OF SOUTH MISSISSIPPI PLLC
Practice address
15190 Community Road
Suite 300
Gulfport, MS 39503-3499
Phone
(228) 831-2229
Fax
(228) 831-9991
NPI assigned
Sep 27, 2006
Last updated
Mar 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Authorized official

Name
Eric J Graham, MD
Title
MD/Partner
Phone
(228) 631-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

15190 Community Road
Suite 300
Gulfport, MS 39503-3499

Mailing address

15190 Community Road
Suite 300
Gulfport, MS 39503-3499
Phone (228) 831-2229

National Provider Directory

National Provider Directory

Locations

15190 Community Rd
Ste 300
Gulfport, MS 39503
Phone (228) 819-8586

15190 Community Rd
Ste 350
Gulfport, MS 39503
Phone (228) 277-1115

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1174614325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY ROAD",
            "address_2": "SUITE 300",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033499",
            "telephone_number": "228-831-2229",
            "fax_number": "228-831-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY ROAD",
            "address_2": "SUITE 300",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033499",
            "telephone_number": "228-831-2229",
            "fax_number": "228-831-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL & NEUROLOGICAL SURGERY OF SOUTH MISSISSIPPI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD/PARTNER",
        "authorized_official_telephone_number": "228-631-2229",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; 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.