Individual provider · Type 1 NPI
Samantha Nicole Glenn Etheredge
Sports Medicine (Family Medicine) Physician · Pascagoula, MS
Practice location
3101 Denny Ave Ste 240
Pascagoula, MS 39581-5307
Fax (228) 875-9998
Mailing address
2101 Highway 90
Gautier, MS 39553-5340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Sports Medicine (Family Medicine) Physician Primary | 207QS0010X | 35673 (MS) |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 3818 (AL) |
Sports Medicine (Family Medicine) Physician: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomecha…
2 other providers at this address
About NPI 1386221844
Samantha Nicole Glenn Etheredge's National Provider Identifier is 1386221844, issued on Mar 29, 2021. The primary taxonomy on file is Sports Medicine (Family Medicine) Physician (207QS0010X), and the practice location is in Pascagoula, MS. The record was last updated on Sep 24, 2025.