Organization
SOUTHERN ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY D GHATAS CRNA (PRESIDENT)
(601) 466-3601
Entity
Organization
Contact information
Practice address
139 FAIRFIELD DR, HATTIESBURG, MS 39402-1303
(601) 466-3601
Mailing address
PO BOX 6, MOUNT OLIVE, MS 39119-0006
(601) 466-3601
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R125620
MS
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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