Organization
SOUTHEAST UROGYNECOLOGY PA
Active
Parent organization
WOMEN'S SPECIALTY CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOMEN'S SPECIALTY CENTER LLC
Authorized official
DR. ROBERT L HARRIS M.D. (DIRECTOR)
(601) 948-6540
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 607-A, JACKSON, MS 39202-1651
(601) 948-6540
Mailing address
501 MARSHALL ST, SUITE 600, JACKSON, MS 39202-1651
(601) 948-6540
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
12/08/2009
Last updated
02/18/2010
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