Organization
SOUTHERN MS HEART CENTER,PA
Active
Organization
SOUTHERN MS HEART CENTER,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA L BONEY (OFFICE MANAGER)
(228) 872-4040
Entity
Organization
Contact information
Practice address
4300 HOSPITAL ST STE 102, PASCAGOULA, MS 39581-5329
(228) 762-1002
(228) 762-1012
Mailing address
4300 HOSPITAL ST STE 102, PASCAGOULA, MS 39581-5329
(228) 762-1002
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014546
—
MN
01
—
CG1009
RAILROAD MEDICARE GRP NO
MS
Enumeration date
07/14/2006
Last updated
05/30/2024
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