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Organization
COASTAL CHRONIC PAIN SERVICES, PLLC
Active
Organization
COASTAL CHRONIC PAIN SERVICES, PLLC
Active
Parent organization
GULFPORT ANESTHESIA SERVICES, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GULFPORT ANESTHESIA SERVICES, P.A.
Authorized official
DIANE SCHULTZ (DIRECTOR)
(228) 831-0204
Entity
Organization
Contact information
Practice address
15190 COMMUNITY RD STE 230B, GULFPORT, MS 39503-3483
(228) 831-0050
(228) 831-1121
Mailing address
15190 COMMUNITY RD STE 230B, GULFPORT, MS 39503-3483
(228) 831-0050
(228) 831-1121
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
11/09/2018
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