360 Medical Group Mississippi PC
Family Medicine in Gulfport, MS. Organization (NPI-2).
NPI number1912818386
StatusActive
Last updated in NPPESSep 15, 2026
Details
- NPI
- 1912818386
- Entity type
- Organization (NPI-2)
- Legal business name
- 360 Medical Group Mississippi PC
- Organization subpart
- No
- Enumeration date
- Sep 15, 2026
- Certification date
- Sep 15, 2026
- Last updated
- Sep 15, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
1302 Magnolia St Unit 1-A5Gulfport, MS 39507-4106
Phone 833-360-6388
Mailing address
270 Trace Colony Park Dr Ste BRidgeland, MS 39157-8810
Authorized official
James Villar
Administrator
8333606388
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