Organization
COASTLINE MEDICAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NGUYEN PHONG HUYNH D.O (PHYSICIAN)
(228) 396-0333
Entity
Organization
Contact information
Practice address
10536 AUTO MALL PKWY, SUITE A, DIBERVILLE, MS 39540-3742
(228) 396-0333
(228) 396-4060
Mailing address
10536 AUTO MALL PKWY, A, DIBERVILLE, MS 39540-3742
(228) 396-0333
(228) 396-4060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19050
MS
207R00000X
Internal Medicine Physician
Primary
19541
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457462954
NPI FOR DR. HUYNH
MS
01
—
1982618310
NPI FOR DR. LE
MS
Enumeration date
04/12/2007
Last updated
01/04/2011
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