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General NPI Number Information
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NPI Number | 1306062641
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Entity Type | Organization
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Legal Business Name | SOUTHERN MS HEART CENTER,PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 3704 BIENVILLE BLVD STE B
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5710
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Country | US
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Telephone | 228-872-4040
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Fax | 228-872-3612
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Provider Business Mailing Address
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Address Line | 3704 BIENVILLE BLVD STE B
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5710
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Country | US
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Telephone | 228-872-4040
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Fax | 228-872-3612
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RHONDA BONEY
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Credential |
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Telephone | 228-872-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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