GULF COAST LIFE, PLLC (NPI# 1700264025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700264025 |
| Entity Type | Organization |
| Organization Name | GULF COAST LIFE, PLLC |
| Practice Address |
4405 E Aloha Dr Diamondhead MS 39525-3380 |
| Practice Telephone | 2282558818 |
| Practice Fax Number | 2282558820 |
| Mailing Telephone | 2282558818 |
| Mailing Fax Number | 2282558820 |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | DR. ERIN ADAM DEWITT (PHYSICIAN) |
| Authorized Official Telephone | 2282558818 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4405 E ALOHA DR |
| City | DIAMONDHEAD |
| State | MS |
| Zip Code | 39525-3380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275848889 | Memorial Hospital At Gulfport | Internal Medicine | 4405 E Aloha Dr, Suite 1, Diamondhead, MS 39525-3380 | 2010-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447762042 | South Mississippi Home Care, LLC | Home Health | 56128 Diamondhead Dr E, Diamondhead, MS 39525 | 2017-11-04 |
| 1093247553 | Deedy Killen | Registered Nurse | 124a Lakeside Villa Bldg C, Diamondhead, MS 39525 | 2017-04-03 |
| 1730502055 | Hancock Medical Health Services | Clinic/Center | 5435 Gex Road, Diamondhead, MS 39525 | 2014-01-22 |
| 1760756423 | Catherine Michelle Brashear | Nurse Practitioner | 4045b Shepards Square, Diamondhead, MS 39525 | 2012-02-28 |
| 1669745303 | Christopher Byron Arcement | Nurse Practitioner | 5435 Gex Rd., Diamondhead, MS 39525 | 2012-02-10 |
| 1184894354 | Gary S. Porter | Nurse Practitioner | 4540 B Shepherds Squard, Diamondhead, MS 39525 | 2008-03-04 |
| 1003007006 | Hancock Medical Center | Clinic/Center | 4540 Shepherd Square, Suite B, Diamondhead, MS 39525 | 2007-08-05 |
| 1346461423 | Charles Eugene Harris | Psychologist | 5427-a Gex Rd, Diamondhead, MS 39525 | 2007-05-02 |
| 1548318025 | Total Rehab Plus LLC | Physical Therapist | 4363 C Leisuretime Dr, Diamondhead, MS 39525 | 2007-01-08 |
| 1356445944 | Cornelia H. Swayze | Social Worker | 4387 Leisure Time Drive, Diamondhead, MS 39525 | 2006-09-12 |
| Find all providers in zip 39525 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336378819 | Amber Hope Mcilwain | Family Medicine | 4540 Shepherd Sq, Diamondhead, MS 39525-3325 | 2009-07-06 |
| 1770620403 | David F. Roberts, Md | Family Medicine | 5435 Gex Rd, Diamondhead, MS 39525-3208 | 2007-01-31 |
| 1508942137 | Erin Adam Dewitt | Family Medicine | 4405 E Aloha Dr Bldg 1a, Diamondhead, MS 39525-3388 | 2006-10-27 |
| 1184732448 | Hancock Family Medicine | Family Medicine | 5400 Indian Hill Blvd, Diamondhead, MS 39525-3334 | 2006-08-28 |
| 1932118965 | David F Roberts | Family Medicine | 4300 Leisure Time Dr, Diamondhead, MS 39525-3241 | 2006-08-07 |
| 1568423697 | Bita Ghaffari | Family Medicine | 4433 Leisure Time Dr., Diamondhead, MS 39525-3334 | 2006-03-29 |
| 1679543102 | Ronald Fulton Kellum | Family Medicine | 4433 Leisure Time, Diamondhead, MS 39525-3259 | 2006-01-26 |
| 1730425802 | Hancock Medical Health Services, Inc. | Family Medicine | 4433 Leisure Time Dr., Diamondhead, MS 39525 | 2012-12-18 |
| 1932410594 | Mmemorial Hospital At Gulfport | Family Medicine | 4300 Leisure Time Dr, Suite A, Diamondhead, MS 39525-3241 | 2010-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
| City | DIAMONDHEAD |
| Zip Code | 39525 |
Please comment or provide details below to improve the information on GULF COAST LIFE, 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.