# MEMORIAL HOSPITAL AT GULFPORT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHYSICIANS CLINIC AT MHG
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982936621
- **Authorized official:** MR. JEFF T STEINER (VP OF FINANCE)
- **Authorized official phone:** (228) 865-3106

## Contact information

- **Practice address:** 1340 BROAD AVE, SUITE 310, GULFPORT, MS 39501-2404
- **Practice address phone:** (228) 575-1400
- **Practice address fax:** (228) 575-1414
- **Mailing address:** PO BOX 555, BILOXI, MS 39533-0555
- **Mailing address phone:** (228) 864-0854
- **Mailing address fax:** (228) 865-1457

## Taxonomy

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

## Other

- **Enumeration date:** 02/05/2010
- **Last updated:** 01/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05900013 | — | MS |