| Bay Plaza Medical Clinic | |
|
618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 | |
| (228) 463-0824 | |
| (228) 463-0827 |
| Full Name | Bay Plaza Medical Clinic |
|---|---|
| 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 |
|---|---|
| Bay Plaza Medical Clinic 1612 31st Ave Gulfport MS 39501-2750 Ph: (228) 865-1453 | Bay Plaza Medical Clinic 618 Blue Meadow Rd Suite 20 Bay St Louis MS 39520-2834 Ph: (228) 463-0824 |
| NPI Number | 1477599280 |
|---|---|
| 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 |
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