Organization
MAGNOLIA ANESTHESIA CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZETTE MORIN (MDMS NPI COMPLIANCE OFFICER)
(210) 598-2800
Entity
Organization
Contact information
Practice address
4209 LAKELAND DR #252, FLOWOOD, MS 39232
(601) 790-3086
Mailing address
4209 LAKELAND DR # 252, FLOWOOD, MS 39232-9212
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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