Organization
SOUTHERN BONE & JOINT SPECIALISTS, PA
Active
Parent organization
SOUTHERN BONE & JOINT SPECIALISTS, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN BONE & JOINT SPECIALISTS, PA
Authorized official
STEPHANIE STEWART MCCRARY (EXECUTIVE DIRECTOR)
(601) 554-7400
Entity
Organization
Contact information
Practice address
1428 AZALEA DR S, WIGGINS, MS 39577-8195
(601) 554-7400
(601) 554-7499
Mailing address
3688 VETERANS MEMORIAL DR STE 200, HATTIESBURG, MS 39401-8246
(601) 554-7400
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015183
—
MS
Enumeration date
09/16/2020
Last updated
09/16/2020
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