Organization
THE MEDICAL ONCOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M DAVIDSON MD (SENIOR PARTNER/PHYSICIAN)
(228) 575-1234
Entity
Organization
Contact information
Practice address
1340 BROAD AVE, SUITE 270, GULFPORT, MS 39501-2404
(228) 575-1234
(228) 575-1240
Mailing address
PO BOX 1210, GULFPORT, MS 39502-1210
(228) 575-1234
(228) 575-1240
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09012355
—
MS
Enumeration date
12/19/2005
Last updated
09/16/2010
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