Organization
SOUTHEAST UROGYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE FERGUSON (ADMINISTRATOR)
(601) 948-6540
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 600, JACKSON, MS 39202-1651
(601) 948-6540
(601) 326-1501
Mailing address
501 MARSHALL ST, SUITE 600, JACKSON, MS 39202-1651
(601) 948-6540
(601) 326-1501
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
Other
Enumeration date
10/26/2012
Last updated
01/20/2016
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