Organization
THE SURGICAL CLINIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY HICKMAN CPA (ADMINISTRATOR)
(601) 948-1411
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 500, JACKSON, MS 39202-1651
(601) 948-1411
(601) 948-0090
Mailing address
501 MARSHALL ST, SUITE 500, JACKSON, MS 39202-1651
(601) 948-1411
(601) 948-0090
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09012031
—
MS
Enumeration date
10/10/2006
Last updated
11/04/2009
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