Provider Demographics
NPI:1649877598
Name:ARTHRITIS INSTITUTE OF MISSISSIPPI, LLC
Entity type:Organization
Organization Name:ARTHRITIS INSTITUTE OF MISSISSIPPI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:WELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-865-9898
Mailing Address - Street 1:PO BOX 2563
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39505-2563
Mailing Address - Country:US
Mailing Address - Phone:228-865-9898
Mailing Address - Fax:228-863-5616
Practice Address - Street 1:9344 THREE RIVERS RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4268
Practice Address - Country:US
Practice Address - Phone:228-865-9898
Practice Address - Fax:228-863-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty