MADISON PHYSICIAN SURGERY CENTER LLC NPI 1073946216

NPI Information

MADISON PHYSICIAN SURGERY CENTER, LLC is an ambulatory surgical clinic center in Flowood, MS. MADISON PHYSICIAN SURGERY CENTER, LLC NPI is 1073946216. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Madison Physicians Surgery Center, Llc.

The provider's business location address is:

4510 LAKELAND DR
FLOWOOD, MS
ZIP 39232-583
Phone: (601) 944-1717
Fax: (601) 944-9780

The provider's authorized official is Meredith Gore Warf .
The authorized official title is Administrator and has the following contact phone number (601) 605-5393.

The CLIA number assigned to this NPI record is 25D2070444 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2013 and was last updated on 6/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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