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Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Other names
The Vein Center of South Central Mississippi
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T CANIZARO CPA (VP OF FINANCE/CFO)
(601) 399-6139
Entity
Organization
Contact information
Practice address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 649-5931
(601) 425-7524
Mailing address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 649-5931
(601) 425-7524
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
02/26/2013
Last updated
03/12/2013
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