# SOUTH CENTRAL REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Vein Center of South Central Mississippi
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023358132
- **Authorized official:** JAMES T CANIZARO CPA (VP OF FINANCE/CFO)
- **Authorized official phone:** (601) 399-6139

## Contact information

- **Practice address:** 1410 JEFFERSON ST, LAUREL, MS 39440-4243
- **Practice address phone:** (601) 649-5931
- **Practice address fax:** (601) 425-7524
- **Mailing address:** 1410 JEFFERSON ST, LAUREL, MS 39440-4243
- **Mailing address phone:** (601) 649-5931
- **Mailing address fax:** (601) 425-7524

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2013
- **Last updated:** 03/12/2013