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General NPI Number Information
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NPI Number | 1972888659
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL CLINICS, INC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 109 N. FRONT ST
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City | SANDERSVILLE
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State | MS
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Zip | 39477
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Country | US
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Telephone | 601-426-7603
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Fax | 601-426-1087
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | LAUREL
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State | MS
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Zip | 39441-0247
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Country | US
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Telephone | 601-426-7603
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Fax | 601-426-1087
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Authorized Official
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Title or Position | DIRECTOR CLINIC SUPPORT
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Name | MONICA MORROW
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Credential |
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Telephone | 601-399-6167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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