Organization
SOUTHERN SPECIALTY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON PENNINGTON MD (CHIEF EXECUTIVE OFFICER)
(601) 985-8296
Entity
Organization
Contact information
Practice address
803 LIBERTY RD, FLOWOOD, MS 39232-9000
(601) 714-1967
(601) 714-1966
Mailing address
803 LIBERTY RD, FLOWOOD, MS 39232-9000
(601) 714-1967
(601) 714-1966
Taxonomy
Speciality
Code
Description
License number
State
2080B0002X
Pediatric Obesity Medicine Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
12/04/2024
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