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Contact Information

GULF COAST INTERNAL MEDICINE PLLC
1721 MEDICAL PARK DR
STE 101
BILOXI, MS39532
 Phone: 228-388-0062
 Fax: 228-388-1701
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GULF COAST INTERNAL MEDICINE PLLC · (Female)

NPI Number 1164450359
Status Active
Credentials
Entity Individual
Enumeration date 06/28/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS Medicaid 09015465
  • MS Other R784087 LICENSE LEIGH DRACE
  • MS Other 16183 LICENSE MARILYN MORA
  • MS Other 17319 LICENSE RACHEL TADLOCK
  • MS Other 13331 LICENSE VALERIE LENOX
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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