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ASA LLC
NPI 1558897744
Clinic/Center - Multi-Specialty in Gulfport, MS

Active since May 07, 2017
1924 30TH AVE, GULFPORT, MS 39501(228) 343-3044(228) 206-4523 Get Directions Write a Review

NPPES record last updated: May 7, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Multi-Specialty

About ASA LLC

This page provides the complete NPI Profile along with additional information for Asa Llc, a provider established in Gulfport, Mississippi operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1558897744 assigned on May 2017. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Mr. Robert Lee Gillum Jr. (Surgical Assistant)

NPI
1558897744 Verify this NPI
Provider Name
ASA LLC
Entity Type
Organization
Location Address
1924 30TH AVE GULFPORT, MS 39501
Location Phone
(228) 343-3044
Location Fax
(228) 206-4523
Mailing Address
1924 30TH AVE GULFPORT, MS 39501
Mailing Phone
(228) 343-3044
Mailing Fax
(228) 206-4523
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-07-2017
Last Update Date
05-07-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities
License State
MS

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. ROBERT LEE GILLUM JR.

Authorized Official Title
SURGICAL ASSISTANT
Authorized Official Phone
(228) 343-3044

Reviews for ASA LLC

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

CANDACE WORSHAM D.O.
Family Medicine
1924 30TH AVE
GULFPORT, MS 39501
Harrison County (228) 863-7117
GARDEN PARK PHYSICIAN SERVICES CORP
Family Medicine
1924 30TH AVE
GULFPORT, MS 39501
Harrison County (228) 832-2004

Frequently Asked Questions

What is ASA LLC's NPI number?

The NPI number assigned to this healthcare provider is 1558897744, enumerated as an "organization" on May 07, 2017.

Where is the provider located?

The provider is located at 1924 30TH AVE GULFPORT, MS 39501 and the phone number is (228) 343-3044.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.