Organization
GULF COAST ABC PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LETICIA GRAYSON MD (MD/OWNER)
(228) 594-8000
Entity
Organization
Contact information
Practice address
1024 TOMMY MUNRO DR STE A, BILOXI, MS 39532-2157
(228) 594-8000
(228) 594-8002
Mailing address
1024 TOMMY MUNRO DRIVE, SUITE A, BILOXI, MS 39532
(228) 594-8000
(228) 594-8002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17609
MS
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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