Provider Demographics
NPI:1174787402
Name:STEPHEN W. MCAULIFFE MEDICAL INC
Entity type:Organization
Organization Name:STEPHEN W. MCAULIFFE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:C
Authorized Official - Last Name:METCALF
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:228-388-8881
Mailing Address - Street 1:180 DEBUYS RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4402
Mailing Address - Country:US
Mailing Address - Phone:228-388-8881
Mailing Address - Fax:228-388-8858
Practice Address - Street 1:180 DEBUYS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4402
Practice Address - Country:US
Practice Address - Phone:228-388-8881
Practice Address - Fax:228-388-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty