| NPI | 1912404930 |
|---|---|
| Doing Business As | DBA - GULFSOUTH PULMONARY, LLC |
| Entity Type | Organization |
| Authorized Contact | BRANDI OGDEN Billing / Credentialing Manager 985-400-5988 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-09-06 |