Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Grove Healthcare

Organization Primary Care Clinic/Center · NPI 1710179395

Magnolia Grove Healthcare is a Primary Care Clinic/Center in Gulfport, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007

Practice location Address checks out

4333 15th St Ste A
Gulfport, MS 39501-2525
Phone: (228) 863-4000
Fax: (228) 863-4003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 12792 (MS)

Record details

NPI number1710179395
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tracey Decena — Office Manager · (228) 863-4000
NPI enumeratedAugust 16, 2007
Last updated in NPPESAugust 16, 2007
Mailing addressPo Box 1040, Gulfport, MS 39502-1040

Other providers in Gulfport