| Organization Name: | GULF COAST PLASTIC AND RECONSTRUCTIVE SURGERY |
| NPI Number: | 1033347653 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIMMIE RICHMOND (BILLING) |
| Mailing Address: | 4509 Gibson Rd Ocean Springs |
| State: | MS US |
| Postal Code: | 395646026 |
| Phone Number: | 2288723993 |
| Fax Number: | 2288723992 |
| NPI Enumeration Date: | 06/23/2009 |
| NPI Last Update Date: | 06/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | 18050 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |