MEDICARE: HUB CITY SURGERY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1447182514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUB CITY SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	120 STONE CREEK BLVD
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-8205
Country	:	US
Telephone Number	:	601-420-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 HWY 98 W
Second Line	:	SUITE 110
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-8557
Country	:	US
Telephone Number	:	601-420-2040
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ROBERT EDWARD MCDAVITT
Credential	:	RN
Telephone Number	:	936-333-4322

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “HUB CITY SURGERY CENTER LLC ” Practice Location

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