Gulfport Obstetrical & Gynecological Clinic, PA
Case Management in Gulfport, MS. Organization (NPI-2).
NPI number1477530657
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1477530657
- Entity type
- Organization (NPI-2)
- Legal business name
- Gulfport Obstetrical & Gynecological Clinic, PA
- Organization subpart
- No
- Enumeration date
- Dec 28, 2005
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251B00000X | Case Management | 82612 | MS | Yes |
Practice location
4502 Old Pass RdGulfport, MS 39501-2585
Phone 228-863-9977 · Fax 228-822-2174
Mailing address
4502 Old Pass RdGulfport, MS 39501-2585
Phone 228-863-9977 · Fax 228-822-2174
Authorized official
David P Burkart
Administrator
2288639977
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