NPI 1356469423

Medical Foundation of South Ms

Organisation Clinical Medical Laboratory Gulfport, MS

Practice location

Address: 1110 Broad Ave Suite 700, Gulfport, MS 39501-8907
Phone: (228) 864-4151
Mailing address: 1612 31st Ave, Gulfport, MS 39501-2750

Authorised official

Name: Randy Robinson
Title: Administrator
Phone: (228) 865-1453

Registered specialties (2)

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

Other Clinical Medical Laboratory providers in Mississippi →

Pediatrics Physician

Allopathic & Osteopathic Physicians Taxonomy 208000000X

Other Pediatrics providers in Mississippi →

Registry record

NPI: 1356469423
Entity type: Organization
NPI issued: 27 Mar 2007
Record last updated: 13 Jun 2008

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.