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Organization

SW MEDIACAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ELIZABETH METALF (PRESIDENT)
(228) 594-8380
Entity
Organization

Contact information

Practice address
2561 PASS RD, SUITE D, BILOXI, MS 39531-2125
(228) 594-8380
(228) 594-8393
Mailing address
2561 PASS RD, SUITE D, BILOXI, MS 39531-2125
(228) 594-8380
(228) 594-8393

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
097339
MS
207QA0401X
Addiction Medicine (Family Medicine) Physician
MS
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
23941
MS
363LF0000X
Family Nurse Practitioner
R791344
MS

Other

Enumeration date
08/05/2015
Last updated
08/06/2015
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