# FOREVER YOUNG MENS HEALTH CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114503190
- **Authorized official:** MR. KENDRICK MCCARTY FNP (OWNER)
- **Authorized official phone:** (228) 669-7293

## Contact information

- **Practice address:** 8837 LORRAINE RD STE B, GULFPORT, MS 39503-5042
- **Practice address phone:** (228) 669-7293
- **Mailing address:** 8837 LORRAINE RD STE B, GULFPORT, MS 39503-5042
- **Mailing address phone:** (228) 669-7293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/22/2021
- **Last updated:** 05/11/2022