Healthcare Provider Details

I. General information

NPI: 1649681693
Provider Name (Legal Business Name): SOUTH CENTRAL CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DUNNBARR SUITE 1
LAUREL MS
39440-1041
US

IV. Provider business mailing address

PO BOX 247
LAUREL MS
39441-0247
US

V. Phone/Fax

Practice location:
  • Phone: 601-426-3421
  • Fax: 601-426-2493
Mailing address:
  • Phone: 601-425-7550
  • Fax: 601-399-6281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MONICA MORROW
Title or Position: DIRECTOR OF CLINIC SUPPORT
Credential:
Phone: 601-399-6167