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Organization
UROLOGIC AMBULATORY SURGERY CENTER, LLC
Active
Organization
UROLOGIC AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEONNE HENRY (DIRECTOR OF OPERATIONS)
(662) 432-0700
Entity
Organization
Contact information
Practice address
499 GLOSTER CREEK VLG STE B8, TUPELO, MS 38801-4633
(662) 432-0700
(662) 846-0566
Mailing address
PO BOX 829, TUPELO, MS 38802-0829
(662) 377-7100
(662) 377-5736
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2017
Last updated
10/24/2023
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