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Contact Information

IRA E GADDY III, MD
10051 LORRAINE ROAD
SUITE A
GULFPORT, MS39503-6001
 Phone: 228-539-7762
 Fax: 228-539-4953
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for IRA E GADDY III · (Male)

NPI Number 1730298506
Status Active
Credentials MD
Entity Individual
Enumeration date 08/29/2006
Last updated 08/10/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 08343
  • MS Medicaid 00013310
  • MS Medicaid 06303560
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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