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CAROLYN KERGOSIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
23453 CENTRAL DR, SAUCIER, MS 39574-7521
(228) 832-7223
(228) 832-0657
Mailing address
PO BOX 475, BILOXI, MS 39533
(228) 374-2494
(228) 374-2713

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12779
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0123167
MS
Enumeration date
03/14/2006
Last updated
10/13/2011
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