Individual
KEVIN RAYMOND BOURGEOIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 865-3151
Mailing address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 865-3151
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27785
MS
207P00000X
Emergency Medicine Physician
325332
LA
Other
Enumeration date
04/17/2018
Last updated
02/14/2023
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