Organization
TYLERTOWN SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POSAVANIKE S GANARAJ M.D. (PRESIDENT)
(601) 876-4961
Entity
Organization
Contact information
Practice address
250 HOSPITAL DR, TYLERTOWN, MS 39667-2020
(601) 876-4961
(601) 876-9172
Mailing address
250 HOSPITAL DR, P.0. BOX 465, TYLERTOWN, MS 39667-2020
(601) 876-4961
(601) 876-9172
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
07415
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016259
—
MS
Enumeration date
08/16/2006
Last updated
08/22/2020
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