Organization
SOUTHERN VASCULAR AND PAIN SURGERY CENTER OLIVE BRANCH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS HODGKISS MD (MD/OWNER)
(901) 350-0978
Entity
Organization
Contact information
Practice address
8990 GERMANTOWN RD STE A, OLIVE BRANCH, MS 38654-8532
(901) 350-0678
Mailing address
921 DENT RD, EADS, TN 38028-9704
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
12/03/2025
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