| Desoto Surgery Clinic Llc | |
|
7580 Clarington Cv Southaven MS 38671 | |
| (662) 536-1545 | |
| (662) 536-8220 |
| Full Name | Desoto Surgery Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 7580 Clarington Cv, Southaven, Mississippi |
| Authorized Official Name and Position | Michael E Foster (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6625361545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Surgery Clinic Llc 7580 Clarington Cv Southaven MS 38671 Ph: (662) 536-1545 | Desoto Surgery Clinic Llc 7580 Clarington Cv Southaven MS 38671 Ph: (662) 536-1545 |
| NPI Number | 1528074184 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 03/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528074184 | NPI | - | NPPES |
| 08232036 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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