Individual
ZACKARY FORDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39502
(601) 672-3173
Mailing address
4500 13TH ST, PO BOX 1810, GULFPORT, MS 39502
(601) 672-3173
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21091
MS
207P00000X
Emergency Medicine Physician
28369
AL
207P00000X
Emergency Medicine Physician
Primary
MD18034
ME
Other
Enumeration date
01/04/2007
Last updated
10/16/2024
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