Organization
MISSISSIPPI SURGICAL SPECIALTIES CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE SMITH CCS-P, CCA (SUPERVISOR)
(662) 453-9305
Entity
Organization
Contact information
Practice address
1401 RIVER ROAD, GREENWOOD, MS 38930-1410
(662) 453-9305
(662) 451-5157
Mailing address
PO BOX 10117, GREENWOOD, MS 38930-0117
(662) 453-9305
(662) 451-5157
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
03952
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018589
—
MS
Enumeration date
01/31/2006
Last updated
07/09/2010
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