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Contact Information

MEMORIAL HOSPITAL AT GULFPORT
4300 LEISURE TIME DR
SUITE B
DIAMONDHEAD, MS39525-3241
 Phone: 228-255-6129
 Fax: 228-255-6431
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MEMORIAL HOSPITAL AT GULFPORT · (Female)

NPI Number 1972835619
Status Active
Credentials
Entity Individual
Enumeration date 02/05/2010
Last updated 02/07/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS Medicaid 02203599
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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