Organization
MID-SOUTH SURGERY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT L SUTTON M.D. (OWNER)
(731) 421-4368
Entity
Organization
Contact information
Practice address
686 W FOREST AVE, JACKSON, TN 38301-3940
(731) 660-8759
(731) 660-8739
Mailing address
PO BOX 3788, JACKSON, TN 38303-3788
(731) 660-8759
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Enumeration date
06/17/2006
Last updated
11/05/2007
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