Organization
RUNNELS PLASTIC SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUDOLPH SCOTT RUNNELS JR. M,D. (OWNER)
(601) 939-9778
Entity
Organization
Contact information
Practice address
1057 RIVER OAKS DRIVE, FLOWOOD, MS 39232-9595
(601) 939-9778
Mailing address
1057 RIVER OAKS DRIVE, FLOWOOD, MS 39232-9595
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
13960
MS
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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