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Contact Information

MEMORIAL HOSPITAL AT GULFPORT
1340 BROAD AVE
SUITE 140
GULFPORT, MS39501-2404
 Phone: 228-818-0563
 Fax: 228-818-0519
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

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

NPI Number 1063663490
Status Active
Credentials
Entity Individual
Enumeration date 10/03/2008
Last updated 01/03/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS Medicaid 05576036
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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