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Contact Information

PHILIP L BERTUCCI, MD
15122 DEDEAUX RD
GULFPORT, MS39503-3120
 Phone: 228-832-1242
 Fax: 228-832-1285
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for PHILIP L BERTUCCI · (Male)

NPI # 1194793299
Status Active
Credentials MD
Entity Individual
Enumeration date 03/14/2006
Last updated 05/25/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MS License # 13141
  • MS Medicaid 00122437
Hospital affiliation(s)
  • MEMORIAL HOSPITAL AT GULFPORT - (Acute Care)
    4500 13TH ST-P O BOX 1810
    GULFPORT, MS 39502
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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