Individual
JOHN RICHARD UNTISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-3627
(228) 376-0047
Mailing address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-3627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02003929A
IN
207RP1001X
Pulmonary Disease Physician
Primary
02003929A
IN
Other
Enumeration date
01/25/2010
Last updated
10/17/2022
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