Organization
PASCAGOULA FAMILY PRACTICE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY HENRY GROFF M.D. (PARTNER)
(228) 762-3466
Entity
Organization
Contact information
Practice address
STE 202, 4211 HOSPITAL STREET, PASCAGOULA, MS 39581-5310
(228) 762-3466
(228) 762-6349
Mailing address
STE 202, 4211 HOSPITAL STREET, PASCAGOULA, MS 39581-5310
(228) 762-3466
(228) 762-6349
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015379
—
MS
01
—
CH5730
RAILROAD MEDICARE
MS
Enumeration date
06/24/2006
Last updated
01/28/2011
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