Garden Park Physician Group-Specialty Care, Llc

LBN: Garden Park Physician Group-Specialty Care, Llc
Garden Park Physician Group-Specialty Care, Llc is an health care organization with primary practice located at 15190 Community Rd Suite 330, Gulfport MS 39503-3485. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Garden Park Physician Group-Specialty Care, Llc can be contacted via phone (228) 539-9100, or through Carlon, Todd via phone (816) 508-4090.

Contact Information

Primary practice address
15190 Community Rd Suite 330 Gulfport MS 39503-3485
Phone: (228) 539-9100
Fax: (228) 539-9133
Website:
Map and Directions
Authorized official contact:
Name: Carlon, Todd
Phone: (816) 508-4090

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X

Profile Details

NPI number 1679668958
LBN Legal business name Garden Park Physician Group-Specialty Care, Llc
DBA Doing business as
Authorized official Carlon, Todd
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2006
Last updated Mar 7th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1679668958 NPPES
Mississippi MEDICAID 3576014
Mississippi MEDICAID 01681729

Popular Providers