Individual
IRA EUGENE GADDY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10051 LORRAINE ROAD, SUITE A, GULFPORT, MS 39503-6001
(228) 539-7762
(228) 539-4953
Mailing address
10051 LORRAINE ROAD, SUITE A, GULFPORT, MS 39503-6001
(228) 539-7762
(228) 539-4953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
08343
MS
207W00000X
Ophthalmology Physician
Primary
08343
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013310
—
MS
05
—
06303560
—
MS
Enumeration date
08/29/2006
Last updated
08/10/2020
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