WALTER JOSPEH SUROWIEC JR. (NPI# 1134142821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134142821 |
| Entity Type | Individual |
| Full Name | WALTER JOSPEH SUROWIEC JR. |
| Credential | D.O.,F.A.C.S. |
| Practice Address |
1340 Broad Ave Ste 420 Gulfport MS 39501-2404 |
| Mailing Address |
Po Box 1810 Gulfport MS 39502-1810 |
| Practice Telephone | 2285751500 |
| Practice Fax Number | 2285751528 |
| Mailing Telephone | 2285751500 |
| Mailing Fax Number | 2285751528 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2014-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 022945 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1498050 | 05 |
| Street Address |
1340 BROAD AVE STE 420 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912904590 | Jesse Pullen Penico | Internal Medicine | 1340 Broad Ave, Suite 300, Gulfport, MS 39501-2404 | 2005-06-28 |
| 1306409040 | Lissa Kelly Baber | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2019-04-18 |
| 1780191577 | Tbd Acquisition II LLC | Social Worker | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2018-01-03 |
| 1629517115 | Delana Mooney | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2017-02-16 |
| 1396299590 | Charles Strange | Nurse Practitioner | 1340 Broad Ave, Suite 450, Gulfport, MS 39501-2404 | 2016-08-05 |
| 1942699988 | Beth Ann Gruzinskas | Nurse Practitioner | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1720477714 | Lacey Grimes Lichtenstein | Nurse Practitioner | 1340 Broad Ave, Gulfport, MS 39501-2404 | 2015-01-14 |
| 1669872974 | Jamie B Varnado | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2014-08-25 |
| 1700121209 | Danielle Ronquille Lipski | Occupational Therapist | 1340 Broad Ave, Suite 270, Gulfport, MS 39501-2404 | 2012-12-10 |
| 1164767778 | Shannon Ann Church | Social Worker | 1340 Broad Ave, Ste 410, Gulfport, MS 39501-2404 | 2012-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588939581 | William Lawson Safley | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11078 Channelside Dr, Gulfport, MS 39503-6049 | 2012-03-09 |
| 1922285378 | Coast Cardiothoracic Surgery, Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1308 44th Ave, Gulfport, MS 39501-2552 | 2008-01-29 |
| 1659679298 | Hector A. Dox Md Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1213 Broad Ave, Suite 3, Gulfport, MS 39501-2475 | 2011-03-07 |
| 1184956815 | Memorial Hospital At Gulfport | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1340 Broad Ave, Suite 420, Gulfport, MS 39501-2404 | 2010-02-05 |
| 1700074085 | Memorial Hospital At Gulfport | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1340 Broad Ave, Suite 420, Gulfport, MS 39501-2404 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932400769 | Stewart Allen Nutting | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6716 Alewa Pl, Diamondhead, MS 39525-3429 | 2010-11-10 |
| 1407072747 | Robert P. N. Shearin | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 308 Hillchase Dr, Madison, MS 39110-8841 | 2007-04-17 |
| 1467571430 | Delta Physician Practices | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1202 Hospital St, Greenville, MS 38703-3213 | 2007-03-28 |
| 1841387727 | David Bruce Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 | 2006-10-10 |
| 1114021722 | Robert G Johnson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3603 Bienville Blvd, Suite 103, Ocean Springs, MS 39564-5727 | 2006-09-12 |
| 1114036290 | David A Geer | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1400 20th Ave, Suite F, Meridian, MS 39301-4111 | 2006-08-30 |
| 1477560050 | James C Gilmore | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 611 Alcorn Dr Ste 200, Corinth, MS 38834-9323 | 2006-08-03 |
| 1740203199 | Hazem Barmada | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1155 Ocean Springs Rd, Ocean Springs, MS 39564-3421 | 2006-07-26 |
| 1609876739 | Clyde Maxwell Hutchinson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 611 Alcorn Dr, Suite 200, Corinth, MS 38834-9321 | 2005-07-29 |
| 1629078746 | David Smith Talton | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801-4934 | 2005-07-29 |
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| 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.