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Organization

GULFPORT ANESTHESIA SERVICES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE SCHULTZ (DIRECTOR)
(228) 831-0204
Entity
Organization

Contact information

Practice address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Mailing address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9013589
MS
05
9014078
MS
Enumeration date
06/17/2006
Last updated
08/22/2020
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