Individual
MATTHEW BOSARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12121 HIGHWAY 49, GULFPORT, MS 39503-3167
(228) 831-1572
(228) 831-1218
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27716
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00371202
—
MS
Enumeration date
04/21/2017
Last updated
08/20/2025
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