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General NPI Number Information
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NPI Number | 1821441080
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Entity Type | Organization
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Legal Business Name | AMORY SURGERY CLINIC, PLLC
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Dates
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Enumeration Date | 07/22/2016
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 1127 EARL FRYE BLVD SUITE B
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City | AMORY
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State | MS
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Zip | 38821-5516
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Country | US
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Telephone | 662-256-3333
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Fax | 662-256-5166
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Provider Business Mailing Address
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Address Line | 1127 EARL FRYE BLVD SUITE B
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City | AMORY
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State | MS
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Zip | 38821-5516
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Country | US
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Telephone | 662-256-3333
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Fax | 662-256-5166
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Authorized Official
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Title or Position | PARTNER
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Name | DR. HOAT M HOANG
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Credential | M.D.
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Telephone | 662-256-3333
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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 | 16728
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License Number State | MS
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