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Organization
BAPTIST DESOTO SURGERY CENTER, LP
Active
Organization
BAPTIST DESOTO SURGERY CENTER, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA FERRELL R.N. (ADMINISTRATOR)
(662) 349-0910
Entity
Organization
Contact information
Practice address
391 SOUTHCREST CIRCLE, SUITE 100, SOUTHAVEN, MS 38671-4775
(662) 349-0910
(662) 349-0911
Mailing address
391 SOUTHCREST CIRCLE, SUITE 100, SOUTHAVEN, MS 38671-4775
(662) 349-0910
(662) 349-0911
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
026
MS
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00239288
—
MS
Enumeration date
02/22/2006
Last updated
12/20/2010
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