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Individual

DR. JOSEPH RICHARD BOSARGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1340 BROAD AVE, SUITE 320, GULFPORT, MS 39501-2404
(228) 575-1775
Mailing address
PO BOX 1810, GULFPORT, MS 39502
(228) 575-1194
(228) 575-2917

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19863
MS
207R00000X
Internal Medicine Physician
ME94065
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
19863
MS
207RP1001X
Pulmonary Disease Physician
Primary
19863
MS

Other

Enumeration date
11/21/2005
Last updated
09/14/2023
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