GULF SOUTH PEDIATRIC CARDIOLOGY LLC NPI 1073653903

NPI Information

GULF SOUTH PEDIATRIC CARDIOLOGY, LLC is a specialist in Gulfport, MS. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GULF SOUTH PEDIATRIC CARDIOLOGY, LLC NPI is 1073653903. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4500 13TH ST
611 BROAD AVENUE
GULFPORT, MS
ZIP 39501-515
Phone: (228) 868-7046
Fax: (228) 575-2120

The provider's authorized official is Lisa Ann Goodwin .
The authorized official title is Practice Manager and has the following contact phone number (228) 868-7046.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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