| Southern Coast Family Medical | |
|
394 Courthouse Rd Suite A Gulfport MS 39507-1865 | |
| (228) 896-4417 | |
| (228) 865-1457 |
| Full Name | Southern Coast Family Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 394 Courthouse Rd, Gulfport, 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 |
|---|---|
| Southern Coast Family Medical 1612 31st Ave Gulfport MS 39501-2750 Ph: (228) 865-1453 | Southern Coast Family Medical 394 Courthouse Rd Suite A Gulfport MS 39507-1865 Ph: (228) 896-4417 |
| NPI Number | 1821233917 |
|---|---|
| Provider Enumeration Date | 12/04/2008 |
| Last Update Date | 12/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821233917 | NPI | - | NPPES |
| 09014940 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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