Organization
VICKSBURG SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN D SUDDERTH M.D. (OWNER)
(601) 831-2799
Entity
Organization
Contact information
Practice address
188 YMCA PLACE, VICKSBURG, MS 39183-3052
(601) 831-2799
(601) 629-2723
Mailing address
188 YMCA PLACE, VICKSBURG, MS 39183-3052
(601) 831-2799
(601) 629-2723
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03081703
—
MS
Enumeration date
01/23/2009
Last updated
02/21/2014
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