Individual
MR. GARY DALTON GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4500 13TH STREET, WOUND CARE, GULFPORT, MS 39501
(228) 867-4499
(228) 867-5027
Mailing address
4500 13TH STREET, WOUND CARE, GULFPORT, MS 39501
(228) 867-4499
(228) 867-5027
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
607576
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05489238
—
MS
Enumeration date
09/16/2006
Last updated
04/05/2018
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