COASTAL EAR, NOSE AND THROAT, HEAD AND NECK SURGERY ASSOCIATES, PLLC (NPI# 1366560435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366560435 |
| Entity Type | Organization |
| Organization Name | COASTAL EAR, NOSE AND THROAT, HEAD AND NECK SURGERY ASSOCIATES, PLLC |
| Practice Address |
407 Security Sq Gulfport MS 39507-1922 |
| Practice Telephone | 2288961987 |
| Practice Fax Number | 2288961315 |
| Mailing Telephone | 2288961987 |
| Mailing Fax Number | 2288961315 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2015-04-23 |
| Authorized Official Name | JASON SMITH (OWNER) |
| Authorized Official Telephone | 2288636617 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
407 SECURITY SQ |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507-1922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
| 1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
| 1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
| 1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
| 1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
| Find all providers in zip 39507 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366993321 | D Balder Md Pllc | Specialist | 15190 Community Rd Ste 210, Gulfport, MS 39503-3483 | 2016-10-14 |
| 1619427374 | Anthony Jamaal Anderson | Specialist | 295 Debuys Rd, Gulfport, MS 39507-2800 | 2016-10-06 |
| 1720368905 | Gulfport Medical Weight Loss | Specialist | 12337 Ashley Dr, Suite F, Gulfport, MS 39503-2753 | 2011-08-19 |
| 1679879936 | Jennifer Boudreaux May | Specialist | 13418 Tara Hills Dr, Gulfport, MS 39503-2332 | 2011-02-04 |
| 1720284946 | The Dermatology Clinic, Pllc | Specialist | 11295 East Taylor Road, Gulfport, MS 39503 | 2007-06-25 |
| 1790802247 | Gulfcoast Pulmonary Consultants Pa | Specialist | 15190 Community Rd Ste 220, Gulfport, MS 39503-3483 | 2007-03-22 |
| 1811084171 | Eric H Wolfson | Specialist | 1340 Broad Street, Suite 440, Gulfport, MS 39501 | 2006-10-06 |
| 1255424727 | Peter Joseph Bernheim | Specialist | 4500 West Railroad Street, Gulfport, MS 39503 | 2006-10-02 |
| 1174614325 | Spinal & Neurological Surgery of South Mississippi Pllc | Specialist | 15190 Community Road, Suite 300, Gulfport, MS 39503-3499 | 2006-09-27 |
| 1558462218 | Eric J Graham | Specialist | 15476 Dedeaux Rd, Gulfport, MS 39503-2637 | 2006-09-26 |
| Find all providers in GULFPORT | ||||
Please comment or provide details below to improve the information on COASTAL EAR, NOSE AND THROAT, HEAD AND NECK SURGERY ASSOCIATES, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.