Internal Medicine Clinic of Picayune
NPI #1528004322 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1528004322
- Entity Type
- Organization
- Organization Name
- Internal Medicine Clinic of Picayune
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jun 21, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 3300 15TH ST
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39501-3901
- Phone
- (228) 864-9669
Authorized Official
- Name
- DR. STANFORD OWEN, MD
- Title
- MD
- Phone
- (228) 864-9669
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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