Organization
UROLOGIC AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEONNE HENRY (DIRECTOR OF OPERATIONS)
(662) 432-0700
Entity
Organization
Contact information
Practice address
499 GLOSTER CREEK VLG STE B8, TUPELO, MS 38801-4633
(662) 432-0700
(662) 846-0566
Mailing address
PO BOX 829, TUPELO, MS 38802-0829
(662) 377-7100
(662) 377-5736
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/09/2017
Last updated
10/24/2023
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