Organization
GULFPORT URGENT CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL B BURWELL D.O. (OWNER)
(228) 863-0500
Entity
Organization
Contact information
Practice address
9344 THREE RIVERS RD, GULFPORT, MS 39503-4268
(228) 863-0500
Mailing address
9344 THREE RIVERS RD, GULFPORT, MS 39503-4268
(228) 863-0500
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
12692
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427012657
INDIVIDUAL NPI
MS
Enumeration date
09/12/2009
Last updated
09/12/2009
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