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Organization

CORINTH SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANGELA JACKSON BSN (ADMINISTRATOR)
(662) 293-2000
Entity
Organization

Contact information

Practice address
401 ALCORN DR STE 1C, CORINTH, MS 38834-9071
(662) 293-2000
(662) 665-0857
Mailing address
401 ALCORN DR STE 1C, CORINTH, MS 38834-9071
(662) 293-2000
(662) 665-0857

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03707532
MS
01
DC8520
RR MEDICARE GROUP NUMBER
MS
Enumeration date
11/10/2005
Last updated
08/22/2020
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