Organization
MEDICAL FOUNDATION OF SOUTH MS
Active
Other names
Pass Road Walk-In Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY ROBINSON (ADMINISTRATOR)
(228) 865-1453
Entity
Organization
Contact information
Practice address
2771 PASS RD, SUITE B, BILOXI, MS 39531-2600
(228) 385-4645
(228) 385-4695
Mailing address
1612 31ST AVE, GULFPORT, MS 39501-2750
(228) 865-1453
(228) 865-1451
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04023236
—
MS
Enumeration date
09/21/2006
Last updated
05/23/2008
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