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Organization
S SONGCHAROEN MD, FACS, PLLC
Active
Organization
S SONGCHAROEN MD, FACS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONGCHAROEN SONGCHAROEN MD (OWNER)
(601) 981-2525
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 315, JACKSON, MS 39216-4643
(601) 981-2525
(601) 981-3152
Mailing address
971 LAKELAND DR, SUITE 654, JACKSON, MS 39216-4643
(601) 981-2525
(601) 981-3152
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
2086S0105X
Surgery of the Hand (Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00015584
—
MS
01
—
1689615486
NPI INDIVIDUAL NUMBER
MS
01
—
240007802
RR MEDICARE
MS
01
—
371563401F
BCBS OF MS
MS
Enumeration date
04/08/2008
Last updated
10/08/2008
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