# GULF MEDICAL, LLC

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

## Provider details

- **NPI number:** 1720123003
- **Authorized official:** MR. DANIEL D SHEPHERD (CLINIC MANAGER)
- **Authorized official phone:** (228) 374-1894

## Contact information

- **Practice address:** 15012 LEMOYNE BLVD, BILOXI, MS 39532-5205
- **Practice address phone:** (228) 374-1894
- **Practice address fax:** (228) 374-9675
- **Mailing address:** 15012 LEMOYNE BLVD, BILOXI, MS 39532-5205
- **Mailing address phone:** (228) 374-1894
- **Mailing address fax:** (228) 374-9675

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 17226 | MS | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 08/22/2020