Organization
PHYSICIANS CARE PLAZA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BILLIE J HOUSEL (CREDENTIALING SPECIALIST)
(228) 865-9898
Entity
Organization
Contact information
Practice address
9344 THREE RIVERS RD, GULFPORT, MS 39503-4268
(228) 865-9898
(228) 863-5616
Mailing address
9344 THREE RIVERS RD, GULFPORT, MS 39503-4268
(228) 865-9898
(228) 863-5616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09295
MS
207Q00000X
Family Medicine Physician
R852805
MS
2084N0400X
Neurology Physician
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06238271
—
MS
01
—
302G701491
MEDICARE
MS
Enumeration date
07/26/2007
Last updated
12/19/2011
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