Organization
SURGERY CLINIC OF PHILADELPHIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT MCNAIR (CHIEF FINANCIAL OFFICER)
(601) 663-1233
Entity
Organization
Contact information
Practice address
1003 HOLLAND AVE, SUITE 101, PHILADELPHIA, MS 39350-2180
(601) 663-1234
(601) 663-1236
Mailing address
1003 HOLLAND AVE, SUITE 101, PHILADELPHIA, MS 39350-2180
(601) 663-1234
(601) 663-1236
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00258672
MEDICARE RAILROAD
MS
Enumeration date
10/27/2006
Last updated
09/22/2017
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