Orange Grove Medical Specialties, P.a.

NPI #1295928893 in Gulfport, Mississippi

Provider Information

NPI Number: 1295928893
Entity Type: Organization
Organization Name: Orange Grove Medical Specialties, P.a.
Primary Specialty: Internal Medicine
Enumeration Date: Aug 27, 2007
Last Updated: May 15, 2015

Practice Location

Address: 15286 COMMUNITY RD
City: Gulfport
State: Mississippi
ZIP Code: 39503-3509
Phone: (228) 832-5151

Authorized Official

Name: LISA LEATHERWOOD
Title: MANAGER
Phone: (228) 832-5151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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