Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Other names
OB Gyn Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CHIOCO MSHA (ASSOCIATE EXECUTIVE DIRECTOR)
(601) 426-4501
Entity
Organization
Contact information
Practice address
203 S 12TH AVE, LAUREL, MS 39440
(601) 426-6961
(601) 426-3449
Mailing address
PO BOX 1649, LAUREL, MS 39441-1649
(601) 426-6961
(601) 426-3449
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016136
—
MS
Enumeration date
06/06/2006
Last updated
12/31/2007
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