Organization
SOUTH CENTRAL CLINICS, INC.
Active
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Other names
SOUTH CENTRAL DIAGNOSTIC CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Authorized official
JAMES T CANIZARO (CFO/VP OF FINANCE)
(601) 399-6139
Entity
Organization
Contact information
Practice address
1440 JEFFERSON ST, SUITE B, LAUREL, MS 39440-4243
(601) 649-6213
(601) 649-6217
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01880574
—
MS
Enumeration date
09/17/2015
Last updated
01/19/2017
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