Gulf Coast Childrens Clinic, PA

NPI #1376887620 in Wiggnis, Mississippi

Provider Information

NPI Number: 1376887620
Entity Type: Organization
Organization Name: Gulf Coast Childrens Clinic, PA
Subpart: Yes (part of a larger organization)
Parent Organization: GULF COAST CHILDRENS CLINIC, PA
Primary Specialty: Pediatrics
Enumeration Date: Nov 26, 2012
Last Updated: Nov 26, 2012

Practice Location

Address: 930 MAIN STREET SUITE A
City: Wiggnis
State: Mississippi
ZIP Code: 39564-0000
Phone: (228) 875-0780

Authorized Official

Name: MEICHELLE HARVEY
Title: ADMINISTRATOR
Phone: (228) 875-0780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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