Gentry, Gary Dalton

Gentry, Gary Dalton is an sole proprietor health care provider with primary practice located at 4500 13Th Street Wound Care, Gulfport MS 39501. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Gentry, Gary Dalton can be contacted via phone (228) 867-4499.

Contact Information

Primary practice address
4500 13Th Street Wound Care Gulfport MS 39501
Phone: (228) 867-4499
Fax: (228) 867-5027
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 607576 Mississippi

Profile Details

NPI number 1659477693
LBN Legal business name Gentry, Gary Dalton
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2006
Last updated Apr 5th, 2018 - about 6 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 1659477693 NPPES
Mississippi MEDICAID 05489238

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