IndividualActive
Samantha Glenn Etheredge
NPI 1386221844 · Sports Medicine (Family Medicine) Physician · Pascagoula, MS
Provider details
- NPI number
- 1386221844
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 35673 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
3101 Denny Ave Ste 240
Pascagoula, MS 39581-5307
Phone: (228) 872-1951
Fax: (228) 875-9998
Approximate (ZIP-level) locationGet directions
Mailing address
2101 Highway 90
Gautier, MS 39553-5340
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2025-09-24
- Certified
- 2025-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.