GULF COAST PLASTIC & RECONSTRUCTIVE SURGERY PLLC NPI 1336259100

NPI Information

  • NPI: 1336259100
  • Provider Name: GULF COAST PLASTIC & RECONSTRUCTIVE SURGERY, PLLC
  • Classification: Surgery - 2086S0122X
  • Specialization: Plastic and Reconstructive Surgery
  • Entity Type: Organization
  • Address: 4509 GIBSON RD
    OCEAN SPRINGS, MS
    ZIP 39564
  • Phone: (228) 872-3993

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NPI Details

GULF COAST PLASTIC & RECONSTRUCTIVE SURGERY, PLLC is a plastic and reconstructive surgery surgery in Ocean Springs, MS. The provider is a surgeon who specializes in plastic and reconstructive surgery. GULF COAST PLASTIC & RECONSTRUCTIVE SURGERY, PLLC NPI is 1336259100. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4509 GIBSON RD
OCEAN SPRINGS, MS
ZIP 39564-026
Phone: (228) 872-3993
Fax: (228) 872-3992

The provider's authorized official is Jimmie G Richmond .
The authorized official title is Billing and has the following contact phone number (228) 872-3993.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 6/10/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0122XSurgeryPlastic and Reconstructive SurgeryYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1302G706033MEDICARE PINMISSISSIPPI

What is NPI?

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This page was last updated on: 11/21/2025

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