Gulfport Obstetrical & Gynecological Clinic, PA
Organization Active NPI Case Management Agency · Gulfport, MS
NPI 1477530657 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1477530657
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- License
- 82612 (MS)
- Legal business name
- GULFPORT OBSTETRICAL & GYNECOLOGICAL CLINIC, PA
- Practice address
- 4502 Old Pass Rd
Gulfport, MS 39501-2585 - Phone
- (228) 863-9977
- Fax
- (228) 822-2174
- NPI assigned
- Dec 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. David P Burkart
- Title
- Administrator
- Phone
- (228) 863-9977
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 82612 | MS | Yes |
Addresses
Primary practice location
4502 Old Pass Rd
Gulfport, MS 39501-2585
Mailing address
4502 Old Pass Rd
Gulfport, MS 39501-2585
Phone (228) 863-9977
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09013169 | Medicaid | MS |
Other providers in Gulfport, MS
- Gulfport Emergency Physicians
- Gulfport Healthcare LLC
- Gulfport Medical Weight Loss
- Gulfport OBGYN Clinic, LLC
- Gulfport Obstetrical & Gynecological Clinic, PA
- Gulfport Outpatient Anesthesia, P.a.
- Gulfport Outpatient Surgery Center
- Gulfport Precision Vision Inc
- Gulfport Premier ABA LLC
- Gulfport School District
All providers in Gulfport, MS · Case Management Agency in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.