Provider Demographics
NPI:1972497238
Name:COAST PHYSICIANS GROUP
Entity type:Organization
Organization Name:COAST PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATWASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRULY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:601-832-5548
Mailing Address - Street 1:1408 HIGHWAY 90 STE 6
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-5456
Mailing Address - Country:US
Mailing Address - Phone:228-471-5217
Mailing Address - Fax:228-471-5217
Practice Address - Street 1:1408 HIGHWAY 90 STE 6
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-5456
Practice Address - Country:US
Practice Address - Phone:228-471-5217
Practice Address - Fax:228-471-5217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty