LANDMARK MEDICAL OF MISSISSIPPI PC NPI 1053818245

NPI Information

LANDMARK MEDICAL OF MISSISSIPPI PC is a general practice in Gulfport, MS. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LANDMARK MEDICAL OF MISSISSIPPI PC NPI is 1053818245. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

14116 CUSTOMS BLVD
GULFPORT, MS
ZIP 39503-164
Phone: (657) 400-5180

The provider's authorized official is Christopher Dennis .
The authorized official title is Chief Medical Officer and has the following contact phone number (657) 400-5180.

The CLIA number assigned to this NPI record is 25D2156482 - other - mobile physician group with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2018 and was last updated on 1/30/2024.

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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