Provider Demographics
NPI:1164877668
Name:THE ISLANDS WEIGHTLOSS CENTER
Entity Type:Organization
Organization Name:THE ISLANDS WEIGHTLOSS CENTER
Other - Org Name:OCEAN SPRINGS MEDI WEIGHTLOSS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-818-0416
Mailing Address - Street 1:1001 N HALSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3121
Mailing Address - Country:US
Mailing Address - Phone:228-875-8001
Mailing Address - Fax:
Practice Address - Street 1:1001 N HALSTEAD RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3121
Practice Address - Country:US
Practice Address - Phone:228-875-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16922207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty