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Organization
GULF COAST ASTHMA AND ALLERGY CLINIC
Active
Organization
GULF COAST ASTHMA AND ALLERGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS CLINTON LEAVENGOOD MD (PRESIDENT)
(228) 432-5955
Entity
Organization
Contact information
Practice address
1025 DIVISION ST, SUITE D, BILOXI, MS 39530-2906
(228) 432-5955
(228) 432-5952
Mailing address
1025 DIVISION ST, SUITE D, BILOXI, MS 39530-2906
(228) 432-5955
(228) 432-5952
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
11243
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110476
—
MS
Enumeration date
09/21/2006
Last updated
03/07/2023
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