Organization
PATTON MEDICAL OF THE GULF COAST INC
Active
Other names
PATTON MEDICAL OF THE GULF COAST INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM KEITH WADE (OWNER)
(228) 872-8685
Entity
Organization
Contact information
Practice address
3002 BIENVILLE BLVD, SUITE C, OCEAN SPRINGS, MS 39564-4354
(228) 872-8685
(228) 872-8685
Mailing address
3002 BIENVILLE BLVD, SUITE C, OCEAN SPRINGS, MS 39564-4354
(228) 872-8685
(228) 872-8685
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440743
—
MS
05
—
809654934A
—
GA
Enumeration date
06/30/2006
Last updated
04/05/2011
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