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General NPI Number Information
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NPI Number | 1427138452
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Entity Type | Organization
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Legal Business Name | COMMUNITY SURGICAL CENTER
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 57 DEWEY ST
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City | LUCEDALE
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State | MS
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Zip | 39452-5707
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Country | US
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Telephone | 601-766-0308
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Fax | 601-766-0309
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Provider Business Mailing Address
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Address Line | PO BOX 1007
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City | LUCEDALE
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State | MS
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Zip | 39452-1007
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Country | US
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Telephone | 601-947-1326
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Fax | 601-947-1331
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. KATHY FENDER
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Credential |
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Telephone | 601-947-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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