Organization
SOUTH CENTRAL CLINICS, INC
Active
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Other names
Ellisville Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Authorized official
CHANCIE KREGER (DIRECTOR)
(601) 399-6152
Entity
Organization
Contact information
Practice address
1203 AVENUE B, ELLISVILLE, MS 39437-2080
(601) 477-8553
(601) 477-9158
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03424516
—
MS
Enumeration date
11/20/2013
Last updated
03/13/2026
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