Matthew Bosarge, D.O.
Family Medicine in Gulfport, MS. Individual provider (NPI-1).
NPI number1336674803
StatusActive
Last updated in NPPESAug 20, 2025
Details
- NPI
- 1336674803
- Entity type
- Individual (NPI-1)
- Name
- Matthew Bosarge
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2017
- Certification date
- Aug 20, 2025
- Last updated
- Aug 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 27716 | MS | Yes |
Practice location
12121 Highway 49Gulfport, MS 39503-3167
Phone 228-831-1572 · Fax 228-831-1218
Mailing address
2101 Highway 90Gautier, MS 39553-5340
Phone 228-497-7576 · Fax 228-497-8869
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