Organization
MADISON AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MARTELL (DIRECTOR)
(360) 402-1433
Entity
Organization
Contact information
Practice address
1883 HIGHWAY 43 S, SUITE J, CANTON, MS 39046-8405
(601) 942-7254
Mailing address
1883 HIGHWAY 43 S, SUITE J, CANTON, MS 39046-8405
(601) 942-7254
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
MS
Other
Enumeration date
06/12/2006
Last updated
07/21/2022
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