Individual
IRENE K KOSKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
835 THAMES AVE, BAY ST LOUIS, MS 39520-5005
(228) 466-4977
(228) 463-0827
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 467-1202
(228) 467-5361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
09338
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018846
—
MS
Enumeration date
07/13/2005
Last updated
07/10/2014
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