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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

NPI Number 1164450359
LBN Legal business name GULF COAST INTERNAL MEDICINE PLLC
Authorized official VALERIE LENOX - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 06/28/2006
Last updated 08/22/2020 - About 6 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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