Organization
GULF COAST NEUROLOGY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LENNON E BOWEN IV M.D. (MANAGER)
(228) 818-9620
Entity
Organization
Contact information
Practice address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-9620
(228) 818-9750
Mailing address
3631 BIENVILLE BLVD, SUITE A, OCEAN SPRINGS, MS 39564-5702
(228) 818-9620
(228) 818-9750
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
646000515
COMMERCIAL
—
Enumeration date
02/01/2007
Last updated
05/23/2008
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