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Organization

MIDSOUTH PAIN TREATMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE J CARNAHAN (OFFICE MANAGER)
(662) 349-9990
Entity
Organization

Contact information

Practice address
122 AIRWAYS PL, SOUTHAVEN, MS 38671-5872
(662) 349-9990
(662) 349-2620
Mailing address
PO BOX 245, SOUTHAVEN, MS 38671-0003
(662) 349-9990
(662) 349-2620

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
06/28/2005
Last updated
12/12/2007
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