Organization
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Active
Other names
Laurel Surgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T CANIZARO CPA (CFO/VP OF FINANCE)
(601) 399-6139
Entity
Organization
Contact information
Practice address
1007 JEFFERSON ST, LAUREL, MS 39440-4350
(601) 649-7802
(601) 428-7841
Mailing address
PO BOX 607, LAUREL, MS 39441-0607
(601) 649-7802
(601) 428-7841
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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