Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Other names
The Vein Center of South Central Mississippi
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T CANIZARO CPA (VP OF FINANCE/CFO)
(601) 399-6139
Entity
Organization
Contact information
Practice address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 649-5931
(601) 425-7524
Mailing address
1410 JEFFERSON ST, LAUREL, MS 39440-4243
(601) 649-5931
(601) 425-7524
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
02/26/2013
Last updated
03/12/2013
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