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

Dr. Jesse Pullen Penico, MD

Individual provider Infectious Disease Physician · NPI 1912904590

Dr. Jesse Pullen Penico, MD is an Infectious Disease Physician in Gulfport, Mississippi. Licensed in Florida, Louisiana and Mississippi. Registered with an NPI since 2005.

Licensed in
FL, LA, MS
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1340 Broad Ave Ste 300
Gulfport, MS 39501-2404
Phone: (228) 575-2700
Fax: (228) 575-2709
Show map & directions

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

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence 21358 (MS)
Infectious Disease Physician Taxonomy 207RI0200X · Licence ME72349 (FL)
Infectious Disease Physician Taxonomy 207RI0200X · Licence 015311 (LA)

Record details

NPI number1912904590
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2005
Last updated in NPPESSeptember 22, 2020
Certification dateSeptember 22, 2020

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