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

Jillian R Dedeaux, CSFA

Individual provider Surgical Physician Assistant · NPI 1710566336

Jillian R Dedeaux, CSFA is a Surgical Physician Assistant in Gulfport, Mississippi. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

14247 N Swan Rd
Gulfport, MS 39503-8551
Phone: (228) 297-6640
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1710566336
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSFA
Sole proprietorNo
NPI enumeratedApril 2, 2021
Last updated in NPPESApril 2, 2021
Certification dateApril 2, 2021
Mailing addressPo Box 7095, Gulfport, MS 39506-7095

Other providers in Gulfport