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618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 | |
(228) 463-0824 | |
(228) 463-0827 |
Full Name | |
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Speciality | Pediatrics |
Location | 618 Blue Meadow Rd, Bay St Louis, Mississippi |
Authorized Official Name and Position | Randy Robinson (ADMINISTRATOR) |
Authorized Official Contact | 2288651453 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1612 31st Ave Gulfport MS 39501-2750 Ph: (228) 865-1453 | 618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 Ph: (228) 463-0824 |
NPI Number | 1477599280 |
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Provider Enumeration Date | 06/21/2006 |
Last Update Date | 05/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477599280 | NPI | - | NPPES |
02976571 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
The Beach Surgical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 952 Green Meadow Rd., Bay St Louis, MS 39520 Phone: 228-467-1386 Fax: 228-467-1770 | |
Rowe S Crowder Iii Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202b Drinkwater Rd, Bay St Louis, MS 39520 Phone: 228-463-1649 Fax: 228-463-0138 | |
Children's International, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 618 Blue Meadow Rd, Bay St Louis, MS 39520 Phone: 228-467-1320 Fax: 228-467-3233 | |