Individual
MRS. TIFFANY JO ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5501 MARVIN SHIELDS BLVD, GULFPORT, MS 39501-9007
(228) 871-4033
(228) 871-3344
Mailing address
5016 EAGLE DR, GULFPORT, MS 39501-3702
(785) 215-1664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
19896
CA
363AM0700X
Medical Physician Assistant
15-01691
KS
Other
Enumeration date
10/21/2008
Last updated
11/07/2024
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