Organization
COMMUNITY SURGICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY FENDER (ADMINISTRATOR)
(601) 947-8181
Entity
Organization
Contact information
Practice address
57 DEWEY ST, LUCEDALE, MS 39452-5707
(601) 766-0308
(601) 766-0309
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 947-1326
(601) 947-1331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09529536
—
MS
01
—
C03242
MEDICARE CAHABA
MS
01
—
DE0674
PALMETTO MEDICARE RAILROA
MS
Enumeration date
10/16/2006
Last updated
04/18/2008
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