Organization
SOUTHERN NEUROSCIENCE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY M. SANFORD (CLINIC ADMINISTRATOR)
(601) 268-5222
Entity
Organization
Contact information
Practice address
105 ASBURY CIR, SUITE A, HATTIESBURG, MS 39402-1397
(601) 268-5222
(601) 296-3508
Mailing address
105 ASBURY CIR, SUITE A, HATTIESBURG, MS 39402-1397
(601) 268-5222
(601) 296-3508
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016160
—
MS
Enumeration date
07/16/2006
Last updated
05/20/2008
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