Individual
SEAN C KERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12261 HIGHWAY 49, SUITE 11, GULFPORT, MS 39503-2975
(228) 867-5185
(228) 867-5189
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 865-1453
(228) 865-1457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20062
MS
207Q00000X
Family Medicine Physician
34974
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07885561
—
MS
05
—
3861661
—
TN
01
—
4114136
BCBST
TN
01
—
DE2565
RR MEDICARE GROUP
TN
01
—
P00344233
RR MEDICARE
TN
Enumeration date
11/06/2006
Last updated
07/10/2014
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