NPI 1073653903

Gulf South Pediatric Cardiology, LLC

Organisation Specialist Gulfport, MS

Practice location

Address: 4500 13th St 611 Broad Avenue, Gulfport, MS 39501-2515
Phone: (228) 868-7046
Fax: (228) 575-2120

Authorised official

Name: Lisa Ann Goodwin
Title: Practice Manager
Phone: (228) 868-7046

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

Other Specialist providers in Mississippi →

Registry record

NPI: 1073653903
Entity type: Organization
NPI issued: 8 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.