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General NPI Number Information
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NPI Number | 1679554190
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Entity Type | Organization
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Legal Business Name | CORINTH SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 ALCORN DR STE 1C
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City | CORINTH
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State | MS
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Zip | 38834-9071
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Country | US
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Telephone | 662-293-2000
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Fax | 662-665-0857
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Provider Business Mailing Address
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Address Line | 401 ALCORN DR STE 1C
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City | CORINTH
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State | MS
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Zip | 38834-9071
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Country | US
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Telephone | 662-293-2000
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Fax | 662-665-0857
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANGELA JACKSON
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Credential | BSN
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Telephone | 662-293-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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