Organization
NORTH MISSISSIPPI AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD WAGES (COO)
(662) 377-4700
Entity
Organization
Contact information
Practice address
589 GARFIELD ST, TUPELO, MS 38801-6301
(662) 377-4700
(662) 377-3101
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00074007
—
MD
Enumeration date
08/31/2006
Last updated
07/11/2007
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