Organization
GULFPORT OUTPATIENT ANESTHESIA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SCHULTZ (DIRECTOR)
(228) 831-0204
Entity
Organization
Contact information
Practice address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Mailing address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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