Organization
BROAD AVENUE URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE ALI D.O. (OWNER)
(228) 314-1340
Entity
Organization
Contact information
Practice address
1104 BROAD AVE, SUITE B, GULFPORT, MS 39501-2414
(228) 314-1340
(228) 314-1342
Mailing address
PO BOX 1248, OCEAN SPRINGS, MS 39566-1248
(228) 314-1340
(228) 314-1342
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2011
Last updated
07/06/2011
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