# MEDICAL FOUNDATION OF SOUTH MS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Coast Internists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922034073
- **Authorized official:** MR. RANDY ROBINSON (ADMINISTRATOR)
- **Authorized official phone:** (228) 865-1453

## Contact information

- **Practice address:** 1340 BROAD AVE, SUITE 310, GULFPORT, MS 39501-2418
- **Practice address phone:** (228) 864-6629
- **Practice address fax:** (228) 864-6669
- **Mailing address:** 1612 31ST AVE, GULFPORT, MS 39501-2750
- **Mailing address phone:** (228) 865-1453
- **Mailing address fax:** (228) 865-1451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2006
- **Last updated:** 04/02/2008