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General NPI Number Information
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NPI Number | 1639295009
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Entity Type | Organization
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Legal Business Name | CENTRAL SURGICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1190 N STATE ST SUITE 502
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City | JACKSON
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State | MS
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Zip | 39202-2413
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Country | US
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Telephone | 601-944-1781
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Fax | 601-353-0439
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Provider Business Mailing Address
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Address Line | 1190 N STATE ST STE 502
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City | JACKSON
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State | MS
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Zip | 39202-2414
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Country | US
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Telephone | 601-944-1781
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Fax | 601-353-0439
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LEE M NICOLS
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Credential | M.D.
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Telephone | 601-944-1781
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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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