Organization · Type 2 NPI
Magnolia Grove Healthcare
Primary Care Clinic/Center · Gulfport, MS
NPI number
1710179395
Active
Practice location
4333 15th St Ste A
Gulfport, MS 39501-2525
Fax (228) 863-4003
Mailing address
PO Box 1040
Gulfport, MS 39502-1040
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 12792 (MS) |
Primary Care Clinic/Center: Definition to come...
Another provider at this address
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- Garlington Haller Ventures, LLCPrimary Care Clinic/Center Gulfport, MS NPI 1659962975
- Sage Health Mississippi LLCPrimary Care Clinic/Center Gulfport, MS NPI 1861103400
- Family Clinic,pllcPrimary Care Clinic/Center Gulfport, MS NPI 1902054679
About NPI 1710179395
Magnolia Grove Healthcare's National Provider Identifier is 1710179395, issued on Aug 16, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Gulfport, MS. The record was last updated on Aug 16, 2007.