Organization
D'IBERVILLE MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY R ADKINS (ADMINISTRATOR)
(228) 861-6049
Entity
Organization
Contact information
Practice address
11516 LAMEY BRIDGE RD, STE 1, DIBERVILLE, MS 39540-2725
(228) 207-4190
(228) 207-4190
Mailing address
PO BOX 1277, BILOXI, MS 39533-1277
(228) 207-4190
(228) 207-4156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
05/02/2019
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