Dauterive, Alton Henry
Dauterive, Alton Henry is an individual health care provider with primary practice located at 1340 Broad Ave Suite 220, Gulfport MS 39501-2404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Dauterive, Alton Henry can be contacted via phone (228) 864-0092.Contact Information
Primary practice address
1340 Broad Ave Suite 220
Gulfport MS 39501-2404
Phone: (228) 864-0092
Fax: (228) 867-6423
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 10998 | Mississippi |
Profile Details
| NPI number | 1558491589 |
|---|---|
| LBN Legal business name | Dauterive, Alton Henry |
| Credentials | MD, FACS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2007 |
| Last updated | Jul 10th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558491589 | NPPES |
| Mississippi | MEDICAID | 00117914 |
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