# LAUREL SURGERY & ENDOSCOPY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAUREL SURGERY & ENDOSCOPY CENTER, LLC
- **Other names:** Laurel Surgery & Endo Anesthesia
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639249394
- **Legal business name:** LAUREL SURGERY & ENDOSCOPY CENTER, LLC
- **Authorized official:** LISA BERGIN (ADMINISTRATOR)
- **Authorized official phone:** (601) 369-2021

## Contact information

- **Practice address:** 1710 W 12TH ST, LAUREL, MS 39440
- **Practice address phone:** (601) 369-2021
- **Mailing address:** 1710 W 12TH ST, LAUREL, MS 39440-2559
- **Mailing address phone:** (601) 369-2021

## Taxonomy

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

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 04/18/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01224218 | — | MS |