Individual
DR. AVIT JOHN GREMILLION III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
962 TOMMY MUNRO DR STE E, BILOXI, MS 39532-2139
(228) 388-7000
(833) 849-9899
Mailing address
962 TOMMY MUNRO DR STE E, BILOXI, MS 39532-2139
(228) 388-7000
(833) 849-9899
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
023984
LA
207W00000X
Ophthalmology Physician
Primary
17239
MS
207WX0107X
Retina Specialist (Ophthalmology) Physician
023984
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
17239
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05109145
—
MS
05
—
05109745
—
MS
05
—
1486787
—
LA
01
—
180000355
MEDICARE RAILROAD
MS
01
—
7812033
AETNA
MS
Enumeration date
12/23/2005
Last updated
12/05/2023
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