Carolyn Kergosien, MD
Individual provider Active NPI Pediatrics Physician · Saucier, MS
NPI 1932177193 · NPPES record last updated Oct 13, 2011
Key facts
- NPI
- 1932177193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 12779 (MS)
- Practice address
- 23453 Central Dr
Saucier, MS 39574-7521 - Phone
- (228) 832-7223
- Fax
- (228) 832-0657
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Family Health Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12779 | MS | Yes |
Addresses
Primary practice location
23453 Central Dr
Saucier, MS 39574-7521
Mailing address
PO Box 475
Biloxi, MS 39533
Phone (228) 374-2494
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123167 | Medicaid | MS |
Other providers in Saucier, MS
- Gulf Coast Education Solutions, LLC
- Catherine Haynes
- Helping Hands
- Mary Ann Hunter
- Allen Karstens
- Kristen Rzomp Ladner
- Nathan Ladner
- Thomas Anthony Mayer
- Molly Morris
- Nateladner LLC
All providers in Saucier, MS · Pediatrics Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2011. 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.