Organization
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Active
Other names
SOUTHWEST UROLOGY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLA ROWLEY (CEO)
(601) 249-1806
Entity
Organization
Contact information
Practice address
1015 DELAWARE AVE STE B, MCCOMB, MS 39648-3827
(601) 250-4344
(601) 250-4345
Mailing address
PO BOX 490, MCCOMB, MS 39649-0490
(601) 249-2701
(601) 249-2195
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06171732
—
MS
Enumeration date
08/21/2006
Last updated
07/14/2023
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