Organization
GULFPORT OUTPATIENT SURGERY CENTER
Active
Other names
GOSC LP
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM E PEAKS (CEO)
(228) 575-7007
Entity
Organization
Contact information
Practice address
1240 BROAD AVE, GULFPORT, MS 39501-2405
(228) 868-1120
(228) 864-0265
Mailing address
PO BOX 877, GULFPORT, MS 39501
(228) 868-1120
(228) 864-0265
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
003
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00074001
—
MS
Enumeration date
08/07/2006
Last updated
08/22/2020
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