Organization
HATTIESBURG AMBULATORY SURGERY CENTER LP
Active
Other names
South Mississippi Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SUPPORT)
(615) 465-7466
Entity
Organization
Contact information
Practice address
39 FRANKLIN RD, SUITE 100, HATTIESBURG, MS 39402-1366
(601) 296-3800
(601) 296-3810
Mailing address
PO BOX 849823, DALLAS, TX 75284-9823
(601) 296-3800
(601) 296-3810
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
024
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04275391
—
MS
01
—
P00172366
MEDICARE RAILROAD
—
Enumeration date
06/22/2006
Last updated
11/01/2007
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