Individual
DR. W. SAM DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5000
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 809-2057
(228) 809-5255
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MS18798
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932477
—
AL
05
—
05179540
—
MS
01
—
646000515
BLUE CROSS OF MS
—
01
—
P00285466
RAILROAD MEDICARE
—
Enumeration date
11/01/2006
Last updated
10/20/2014
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