PATTON MEDICAL OF THE GULF COAST INC (NPI# 1063440584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063440584 |
| Entity Type | Organization |
| Organization Name | PATTON MEDICAL OF THE GULF COAST INC |
| Other Organization Name | PATTON MEDICAL OF THE GULF COAST INC |
| Practice Address |
3002 Bienville Blvd Suite C Ocean Springs MS 39564-4354 |
| Practice Telephone | 2288728685 |
| Practice Fax Number | 2288728685 |
| Mailing Telephone | 2288728685 |
| Mailing Fax Number | 2288728685 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2011-04-05 |
| Authorized Official Name | MR. WILLIAM KEITH WADE (OWNER) |
| Authorized Official Telephone | 2288728685 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 809654934A | 05 | |
| MS | 00440743 | 05 |
| Other Name | Type Code |
|---|---|
| PATTON MEDICAL OF THE GULF COAST INC | Doing Business As Name - Organization |
| Street Address |
3002 BIENVILLE BLVD SUITE C |
| City | OCEAN SPRINGS |
| State | MS |
| Zip Code | 39564-4354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174521918 | Patton Medical of The Gulf Coast, Inc. | Durable Medical Equipment & Medical Supplies | 3002 Bienville Blvd, Ocean Springs, MS 39564-4354 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996401 | Shelby Bourgeois | Speech-Language Pathologist | 108 Heron Park Pl, Ocean Springs, MS 39564 | 2020-09-10 |
| 1467010520 | Rachel Stephenie Knox | Student in an Organized Health Care Education/Training Program | 81mdss/gme 301 Fisher St., Rm 1g123, Keesler Afb, MS 39564 | 2019-06-04 |
| 1457839292 | Polly Anne Lampon | Registered Nurse | 2301 Rue Beaux Chenes, Ocean Springs, MS 39564 | 2018-08-03 |
| 1578062725 | Gulf Coast Sleep Medicine LLC | Clinic/Center | 2112 Bienville Blvd., Suite P, Ocean Springs, MS 39564 | 2018-02-02 |
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1386016749 | L. Randy Buntyn, D.m.d., Pllc | Dentist | 1203 Government St., Ocean Springs, MS 39564 | 2015-10-26 |
| 1467835629 | Msmobileyes Inc. | Optometrist | 2510 Bileville Blvd, Ocean Springs, MS 39564 | 2015-07-07 |
| 1659760999 | Clark Jamison Levi | Pharmacist | 1019 Government Street Suite F & D, Ocean Springs, MS 39564 | 2015-01-09 |
| 1932545480 | Therese Anne Hanna | Nurse Practitioner | 6900 Washington Avenue, Ocean Springs, MS 39564 | 2013-05-10 |
| 1346589421 | Jennah Claine Ladner | Nurse Practitioner | 1137 Ocean Springs Road, Ocean Springs, MS 39564 | 2013-02-08 |
| Find all providers in zip 39564 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010645 | The Royal Studio | Prosthetic/Orthotic Supplier | 246 Briarwood Dr Ste 102, Jackson, MS 39206-3027 | 2020-07-17 |
| 1881219046 | Color Me Jazzy | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-560, Ridgeland, MS 39157-4861 | 2020-06-13 |
| 1154945418 | Dream Hair Care | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste E, Hattiesburg, MS 39402-1006 | 2020-06-02 |
| 1578186409 | Perfectly Imperfect Wig Collection | Prosthetic/Orthotic Supplier | 418 Carrollton Ave, Lexington, MS 39095-3212 | 2020-05-27 |
| 1366064263 | Lavishinglux Hair Imports | Prosthetic/Orthotic Supplier | 200 Belle Chasse Cir, Jackson, MS 39212-3164 | 2020-05-13 |
| 1275155749 | Fearless Beauty Company | Prosthetic/Orthotic Supplier | 611 S Pear Orchard Rd # 771, Ridgeland, MS 39157-4836 | 2020-05-07 |
| 1982225850 | Luxury Locs | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste D, Hattiesburg, MS 39402-1006 | 2020-05-02 |
| 1518587914 | Bmb Medical Beautique | Prosthetic/Orthotic Supplier | 6515 Goodman Rd Ste 300, Olive Branch, MS 38654-7333 | 2020-04-26 |
| 1316567795 | Gyzele's Hair Boutique | Prosthetic/Orthotic Supplier | 1104 W Sunflower Rd, Cleveland, MS 38732-2440 | 2020-04-25 |
| 1083234462 | Shear Beauty 31 Hair Studio | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-573, Ridgeland, MS 39157-4861 | 2020-04-25 |
| Find all providers with the same taxonomy | ||||
| City | OCEAN SPRINGS |
| Zip Code | 39564 |
Please comment or provide details below to improve the information on PATTON MEDICAL OF THE GULF COAST INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.