Individual
MS. MARY M ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3603 BIENVILLE BLVD STE 102, OCEAN SPRINGS, MS 39564-5736
(228) 818-9620
(228) 818-9750
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00637
MS
363AM0700X
Medical Physician Assistant
PA00637
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00088561
—
MS
Enumeration date
02/11/2022
Last updated
05/10/2023
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