# 360 MEDICAL GROUP MISSISSIPPI PC

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

## Provider details

- **NPI number:** 1912818386
- **Authorized official:** JAMES VILLAR (ADMINISTRATOR)
- **Authorized official phone:** (833) 360-6388

## Contact information

- **Practice address:** 1302 MAGNOLIA ST UNIT 1-A5, GULFPORT, MS 39507-4106
- **Practice address phone:** (833) 360-6388
- **Mailing address:** 270 TRACE COLONY PARK DR STE B, RIDGELAND, MS 39157-8810

## Taxonomy

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

## Other

- **Enumeration date:** 09/15/2026
- **Last updated:** 09/15/2026