Organization
GULF COAST CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEICHELLE HARVEY (ADMINISTRATOR)
(228) 875-0780
Entity
Organization
Contact information
Practice address
3650 GROVELAND RD, OCEAN SPRINGS, MS 39564-5754
(228) 875-0780
(228) 875-1009
Mailing address
1720A MEDICAL PARK DR, SUITE 200, BILOXI, MS 39532-2129
(228) 396-2726
(228) 875-1009
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05258597
—
MS
Enumeration date
06/09/2016
Last updated
06/09/2016
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