COASTAL EYE SURGERY CENTER
Ambulatory Health at Dedeaux Rd, Gulfport, MS

License number
Mississippi 012410
Category
Ambulatory Health
Type
Ophthalmologic Surgery
Owner
Name: DONALD W BENEFIELD MD
Title: PRESIDENT
Phone: (228) 328-0972
Address
Address
14245 Dedeaux Rd, Gulfport, MS 39503
National Provider ID: 1669757761
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Coastal Eye Surgery Center, Inc

14225 Dedeaux Rd, Gulfport, MS 39503

Status:
Inactive
Industry:
Medical Doctor's Office
State ID:
990739
Ophthalmic Technicians:
Kaleel G Salloum Jr (Incorporator), 1611 24 Ave SUITE B, Gulfport, MS 39501,Md Donald Benefield (President), 14225 Dedeaux Rd, Gulfport, MS 39503,Margie Allex (Director), 14225 Dedeaux Rd, Gulfport, MS 39503,...
Agent:
Donald Benefield,14245 Dedeaux Rd, Gulfport, MS 39503 (Physical)

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