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Organization
EAR,NOSE & THROAT SURGICAL CLINIC OF SOUTH CENTRAL MS
Active
Organization
EAR,NOSE & THROAT SURGICAL CLINIC OF SOUTH CENTRAL MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL WAYNE STEVENS II M.D. (PRESIDENT)
(061) 649-9706
Entity
Organization
Contact information
Practice address
306 S 12TH AVE, LAUREL, MS 39440-4327
(601) 649-9706
(601) 649-9708
Mailing address
306 S 12TH AVE, LAUREL, MS 39440-4327
(601) 649-9706
(601) 649-9708
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
15762
MS
Other
Enumeration date
06/08/2007
Last updated
05/21/2008
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