Organization
SPINAL & NEUROLOGICAL SURGERY OF SOUTH MS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE L FAYARD PT (PT CLINIC MANAGER)
(228) 832-8327
Entity
Organization
Contact information
Practice address
11010 DAVID ST, SUITE B, GULFPORT, MS 39503-3481
(828) 832-8327
Mailing address
11010 DAVID ST, SUITE B, GULFPORT, MS 39503-3481
(828) 832-8327
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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