# MEDICAL FOUNDATION OF SOUTH MS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Coast Family Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821233917
- **Authorized official:** MR. RANDY ROBINSON (ADMINISTRATOR)
- **Authorized official phone:** (228) 865-1453

## Contact information

- **Practice address:** 394 COURTHOUSE RD, SUITE A, GULFPORT, MS 39507-1865
- **Practice address phone:** (228) 896-4417
- **Practice address fax:** (228) 865-1457
- **Mailing address:** 1612 31ST AVE, GULFPORT, MS 39501-2750
- **Mailing address phone:** (228) 865-1453
- **Mailing address fax:** (228) 865-1457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2008
- **Last updated:** 12/04/2008