Organization
BILOXI OB GYN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATISHA MARIE WISNIEWSKI (PRACTICE ADMINISTRATOR)
(228) 702-1500
Entity
Organization
Contact information
Practice address
1720A MEDICAL PARK DR, SUTIE 300, BILOXI, MS 39532-2129
(228) 702-1500
(228) 702-1505
Mailing address
1720A MEDICAL PARK DR, SUITE 300, BILOXI, MS 39532-2129
(228) 702-1500
(228) 702-1505
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
04/07/2008
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