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Organization

GULF COAST CHILDRENS CLINIC, PA

Active
Parent organization
GULF COAST CHILDRENS CLINIC, PA
Other names
Gulf Coast Childrens Clinic at Wiggins
Organization subpart
Yes

Provider details

NPI number
Legal business name
GULF COAST CHILDRENS CLINIC, PA
Authorized official
MEICHELLE HARVEY (ADMINISTRATOR)
(228) 875-0780
Entity
Organization

Contact information

Practice address
930 MAIN STREET SUITE A, WIGGNIS, MS 39564-0000
(228) 875-0780
(228) 875-1009
Mailing address
3650 GROVELAND RD, OCEAN SPRINGS, MS 39564-5754
(228) 875-0780
(228) 875-1009

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
11/26/2012
Last updated
11/26/2012
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