Organization
CENTER FOR DIGESTIVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ELLIS (OFFICE MANAGER)
(662) 680-5565
Entity
Organization
Contact information
Practice address
589 GARFIELD ST, TUPELO, MS 38801-6301
(662) 680-5565
(662) 680-5654
Mailing address
PO BOX 3488, TUPELO, MS 38803-3488
(662) 680-5565
(662) 680-5654
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
25C0001058
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03208889
—
MS
Enumeration date
05/13/2006
Last updated
10/10/2008
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