Organization
STARFISH FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN YALTAH MULLEN M.D. (OWNER)
(228) 396-5022
Entity
Organization
Contact information
Practice address
13066 SHRINERS BLVD, SUITE A AND B, BILOXI, MS 39532-8616
(228) 396-5022
(228) 396-5028
Mailing address
13066 SHRINERS BLVD, SUITE A AND B, BILOXI, MS 39532-8616
(228) 396-5022
(228) 396-5028
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
14226
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06103001
—
MS
Enumeration date
06/02/2014
Last updated
06/02/2014
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