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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558491589 NPPES
Mississippi MEDICAID 00117914

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