Organization
GSW MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN NOLAN GRADY MD (MEMBER)
(318) 341-2335
Entity
Organization
Contact information
Practice address
4500 13TH ST FL 3, GULFPORT, MS 39501-2515
(318) 341-2335
Mailing address
7470 WOODLAWN CT, PASS CHRISTIAN, MS 39571-5539
(318) 341-2335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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