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GARDEN PARK PHYSICIAN SERVICES CORP NPI 1871523423


NPI Information

NPI: 1871523423
Provider Name: GARDEN PARK PHYSICIAN SERVICES CORP

Doing Business As: FAMILY MEDICAL CENTER OF ORANGE GROVE

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
12330 ASHLEY DR
GULFPORT, MS
ZIP 39503
Phone: (228) 863-7117
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GARDEN PARK PHYSICIAN SERVICES CORP 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. GARDEN PARK PHYSICIAN SERVICES CORP NPI is 1871523423. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Family Medical Center Of Orange Grove.

The provider's business location address is:

12330 ASHLEY DR
GULFPORT, MS
ZIP 39503-737
Phone: (228) 863-7117
Fax: (228) 868-9388

The provider's authorized official is Robert Lagesse .
The authorized official title is Vice President and has the following contact phone number (504) 988-7044.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 10/10/2007.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
109016019MEDICAIDMISSISSIPPI
2C02318MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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