Organization
COASTAL EYE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W BENEFIELD MD (PRESIDENT)
(228) 328-0972
Entity
Organization
Contact information
Practice address
14245 DEDEAUX RD, GULFPORT, MS 39503-3369
(228) 328-0972
Mailing address
14245 DEDEAUX RD, GULFPORT, MS 39503-3369
(228) 328-0972
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
012410
MS
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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