Medical Foundation of South Ms

NPI #1922034073 in Gulfport, Mississippi

Provider Information

NPI Number: 1922034073
Entity Type: Organization
Organization Name: Medical Foundation of South Ms
Primary Specialty: Internal Medicine
Enumeration Date: Jun 23, 2006
Last Updated: Apr 2, 2008

Practice Location

Address: 1340 BROAD AVE
Address 2: SUITE 310
City: Gulfport
State: Mississippi
ZIP Code: 39501-2418
Phone: (228) 864-6629

Authorized Official

Name: MR. RANDY ROBINSON
Title: ADMINISTRATOR
Phone: (228) 865-1453

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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