# SURGERY CLINIC OF PHILADELPHIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861578536
- **Authorized official:** MR. SCOTT MCNAIR (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (601) 663-1233

## Contact information

- **Practice address:** 1003 HOLLAND AVE, SUITE 101, PHILADELPHIA, MS 39350-2180
- **Practice address phone:** (601) 663-1234
- **Practice address fax:** (601) 663-1236
- **Mailing address:** 1003 HOLLAND AVE, SUITE 101, PHILADELPHIA, MS 39350-2180
- **Mailing address phone:** (601) 663-1234
- **Mailing address fax:** (601) 663-1236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 09/22/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P00258672 | MEDICARE RAILROAD | MS |