Magnolia Grove Healthcare
Magnolia Grove Healthcare provides Primary Care Clinic/Center services in Gulfport, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.
- Licensed in
- MS
- In the registry since
- 2007
Practice location Address checks out
4333 15th St Ste AGulfport, MS 39501-2525 Not confirmed with CMS for 19 years — call before visiting
Phone: (228) 863-4000
Fax: (228) 863-4003
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Primary Care Clinic/Center (primary) | Taxonomy 261QP2300X · Licence 12792 (MS) |
|---|
Record details
| NPI number | 1710179395 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tracey Decena — Office Manager · (228) 863-4000 |
| NPI enumerated | August 16, 2007 |
| Last updated in NPPES | August 16, 2007 |
| Mailing address | Po Box 1040, Gulfport, MS 39502-1040 |
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