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BILOXI OB GYN CLINIC NPI 1255454708


NPI Information

NPI: 1255454708
Provider Name: BILOXI OB GYN CLINIC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 25D0319602

Address:
147 REYNOIR ST
SUITE 105
BILOXI, MS
ZIP 39530
Phone: (228) 436-6658
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BILOXI OB GYN CLINIC is a gynecology obstetrics gynecology in Biloxi, MS. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee BILOXI OB GYN CLINIC NPI is 1255454708. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

147 REYNOIR ST
SUITE 105
BILOXI, MS
ZIP 39530-109
Phone: (228) 436-6658
Fax: (228) 432-9455

The provider's authorized official is Latisha Marie Wisniewski .
The authorized official title is Practice Administrator and has the following contact phone number (228) 436-6658.

The CLIA number assigned to this NPI record is 25D0319602 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/9/2007 and was last updated on 4/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyMISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C00958MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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