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Organization

SOUTHERN MS HEART CENTER,PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMY E COUCH (OFFICE MANAGER)
(228) 762-1002
Entity
Organization

Contact information

Practice address
7001 HIGHWAY 614, HURLEY, MS 39555
(228) 762-1002
(228) 762-1012
Mailing address
4300 HOSPITAL ST STE 102, PASCAGOULA, MS 39581-5329
(228) 762-1002
(228) 762-1012

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09014546
MS
01
CG1009
RAILROAD MEDICARE
MS
Enumeration date
11/14/2011
Last updated
11/14/2011
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