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Organization
HATTIESBURG AMBULATORY SURGERY CENTER LP
Active
Organization
HATTIESBURG AMBULATORY SURGERY CENTER LP
Active
Other names
South Mississippi Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SUPPORT)
(615) 465-7466
Entity
Organization
Contact information
Practice address
39 FRANKLIN RD, SUITE 100, HATTIESBURG, MS 39402-1366
(601) 296-3800
(601) 296-3810
Mailing address
PO BOX 849823, DALLAS, TX 75284-9823
(601) 296-3800
(601) 296-3810
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
024
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04275391
—
MS
01
—
P00172366
MEDICARE RAILROAD
—
Enumeration date
06/22/2006
Last updated
11/01/2007
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