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Individual

SOMPRASONG SONGCHAROEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
160 FOUNTAINS BLVD STE B, MADISON, MS 39110
(601) 981-2525
(601) 981-3152
Mailing address
160 FOUNTAINS BLVD STE B, MADISON, MS 39110-6343
(601) 981-2525
(601) 981-3152

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
07162
MS
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
07162
MS
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
07162
MS
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
07162
MS

Other

Enumeration date
06/10/2006
Last updated
11/19/2018
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