Provider Demographics
NPI:1265694129
Name:DEMPSEY, MARTHA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ANN
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 BEACH DR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-1553
Mailing Address - Country:US
Mailing Address - Phone:228-897-4450
Mailing Address - Fax:228-897-4450
Practice Address - Street 1:1800 BEACH DR
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-1553
Practice Address - Country:US
Practice Address - Phone:228-897-4450
Practice Address - Fax:228-897-4450
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20839207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03357291Medicaid
MS12222969OtherCAQH
MS03357291Medicaid