Organization
GARDEN PARK PHYSICIAN SERVICES CORP.
Active
Other names
Family Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LEGESSE (VICE PRESIDENT)
(615) 373-7630
Entity
Organization
Contact information
Practice address
15190 COMMUNITY RD, SUITE 330, GULFPORT, MS 39503-3485
(228) 832-3075
(228) 832-9095
Mailing address
15190 COMMUNITY RD, SUITE 330, GULFPORT, MS 39503-3485
(228) 832-3075
(228) 832-9095
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08838517
—
MS
Enumeration date
09/29/2006
Last updated
04/20/2008
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