Organization
SOUTHERN MS HEART CENTER,PA
Active
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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