Provider Demographics
NPI:1790802247
Name:GULFCOAST PULMONARY CONSULTANTS PA
Entity Type:Organization
Organization Name:GULFCOAST PULMONARY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:YON
Authorized Official - Suffix:
Authorized Official - Credentials:ECT
Authorized Official - Phone:228-539-3480
Mailing Address - Street 1:15190 COMMUNITY RD STE 220
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3483
Mailing Address - Country:US
Mailing Address - Phone:228-539-3480
Mailing Address - Fax:228-539-3318
Practice Address - Street 1:15190 COMMUNITY RD STE 220
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3483
Practice Address - Country:US
Practice Address - Phone:228-539-3480
Practice Address - Fax:228-539-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty