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
Update your record
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