Individual
MR. PAUL G MATHERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1924 E PASS RD, GULFPORT, MS 39507-3715
(228) 388-4862
(228) 388-2556
Mailing address
1924 E PASS RD, GULFPORT, MS 39507-3715
(228) 388-4862
(228) 388-2556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09445
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000018917
—
MS
Enumeration date
12/28/2006
Last updated
10/07/2020
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