# SOUTHERN EYE SURGERY AND LASER CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Anesthesia
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295244226
- **Authorized official:** KIPER C NELSON MD (OWNER, LLC MEMBER)
- **Authorized official phone:** (601) 264-3937

## Contact information

- **Practice address:** 1923 W 10TH ST, LAUREL, MS 39440-2538
- **Practice address phone:** (601) 264-3937
- **Practice address fax:** (601) 264-3937
- **Mailing address:** 1420 S 28TH AVE, HATTIESBURG, MS 39402-3107
- **Mailing address phone:** (601) 264-3937
- **Mailing address fax:** (601) 264-5930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2017
- **Last updated:** 09/21/2017