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General NPI Number Information
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NPI Number | 1184022485
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI CENTER FOR PLASTIC SURGERY
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 200 W JACKSON ST SUITE 100
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City | RIDGELAND
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State | MS
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Zip | 39157-2310
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Country | US
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Telephone | 769-300-4055
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Fax | 601-427-5864
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Provider Business Mailing Address
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Address Line | PO BOX 13582
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City | JACKSON
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State | MS
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Zip | 39236-3582
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Country | US
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Telephone | 769-300-4055
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Fax | 601-427-5864
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PAIGE C. SWINDLE
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Credential |
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Telephone | 769-300-4055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 19109
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License Number State | MS
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