Healthcare Provider Details

I. General information

NPI: 1962826743
Provider Name (Legal Business Name): SURGICALFIRST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 ROY O'NEAL RD
PERKINSTON MS
39573-3454
US

IV. Provider business mailing address

272 ROY O'NEAL RD
PERKINSTON MS
39573-3454
US

V. Phone/Fax

Practice location:
  • Phone: 228-234-7324
  • Fax: 888-329-6432
Mailing address:
  • Phone: 228-234-7324
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: LATRICIA R ALLEN
Title or Position: PRESIDENT
Credential: CSFA
Phone: 228-234-7324