NPI 1346677812 · live from the CMS NPI Registry
Memorial Hospital At Gulfport
Family Medicine in Diamondhead, MS. National Provider Identifier 1346677812, active.
NPI record
| NPI | 1346677812 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 4300 Leisure Time Dr, Suite A, Diamondhead, MS 39525 |
| Practice phone | 228-255-4300 |
| Mailing address | Po Box 1810, Gulfport, MS 39502 |
| Enumerated | September 30, 2013 |
| Last updated | January 9, 2024 |
| Authorized official | Peggy Noonan, Physician Business Services Dir. |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology | 207RG0100X | — |
| Internal Medicine, Nephrology | 207RN0300X | — |
| Neurological Surgery | 207T00000X | — |
| Orthopaedic Surgery | 207X00000X | — |
| Nurse Practitioner | 363L00000X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.