Organization
GARDEN PARK PHYSICIAN GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS R. JOSEPH (VP)
(615) 373-7600
Entity
Organization
Contact information
Practice address
416 E PASS RD, GULFPORT, MS 39507-3236
(228) 896-6505
(228) 896-6509
Mailing address
3 MARYLAND FARMS, SUITE 250, BRENTWOOD, TN 37027-5005
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01622395
—
MS
05
—
05826810
—
MS
05
—
08838517
—
MS
05
—
09016020
—
MS
05
—
09016021
—
MS
05
—
09106019
—
MS
05
—
1285660688
—
AL
Enumeration date
06/25/2006
Last updated
03/15/2013
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