Gulf Medical, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

17226 Issued in MS

Legal business name

GULF MEDICAL, LLC

Practice address

15012 Lemoyne Blvd
Biloxi, MS 39532-5205

Phone

(228) 374-1894

Fax

(228) 374-9675

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Daniel D Shepherd

Title

Clinic Manager

Phone

(228) 374-1894

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720123003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15012 LEMOYNE BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395325205",
            "telephone_number": "228-374-1894",
            "fax_number": "228-374-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15012 LEMOYNE BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395325205",
            "telephone_number": "228-374-1894",
            "fax_number": "228-374-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "228-374-1894",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "17226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gulf Coast Veterans Health Care System
• Gulf Coast Wellness Center Inc
• Gulf Shores Adult Day Care
• Gulfsouth Radiology P a
• Ginger A Gunn, PH.D.
• Renee Gusta
• Jacob Gutman, DO

• Internal Medicine Physician in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.