PREVENTATIVE MEDICINE AND PRIMARY CARE NPI 1720402266

NPI Information

  • NPI: 1720402266
  • Provider Name: PREVENTATIVE MEDICINE AND PRIMARY CARE
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 3300 LADNIER RD
    GAUTIER, MS
    ZIP 39553
  • Phone: (228) 497-2652

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NPI Details

PREVENTATIVE MEDICINE AND PRIMARY CARE is a primary care clinic center in Gautier, MS. PREVENTATIVE MEDICINE AND PRIMARY CARE NPI is 1720402266. The provider is registered as an organization entity type.

The provider's business location address is:

3300 LADNIER RD
GAUTIER, MS
ZIP 39553-909
Phone: (228) 497-2652

The provider's authorized official is Rick Dean Hoover .
The authorized official title is Owner and has the following contact phone number (228) 497-2652.

The enumeration date for this NPI number is 2/4/2014 and was last updated on 2/4/2014.

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
1261QP2300XClinic/CenterPrimary Care15373MISSISSIPPIYes

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
100118337MEDICAIDMISSISSIPPI
2G50099MEDICARE UPIN

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: 11/21/2025

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