| Medical Foundation Of South Ms | |
|
5120 Beatline Rd Suite B Long Beach MS 39560-3815 | |
| (228) 868-4294 | |
| (228) 868-4293 |
| Full Name | Medical Foundation Of South Ms |
|---|---|
| Speciality | Family Medicine |
| Location | 5120 Beatline Rd, Long Beach, 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 |
|---|---|
| Medical Foundation Of South Ms 1612 31st Ave Gulfport MS 39501-2750 Ph: (228) 865-1453 | Medical Foundation Of South Ms 5120 Beatline Rd Suite B Long Beach MS 39560-3815 Ph: (228) 868-4294 |
| NPI Number | 1174542146 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 05/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174542146 | NPI | - | NPPES |
| 09083390 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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