NPI 1033190129

Mae Physicians Surgery Center, LLC

Organisation Ambulatory Surgical Clinic/Center Jackson, MS

Practice location

Address: 1190 N State St STE 102, Jackson, MS 39202-2413
Phone: (601) 968-1790
Fax: (601) 292-4531
Mailing address: PO Box 12673, Jackson, MS 39236-2673

Authorised official

Name: Carla Glaze
Title: Administrator
Phone: (601) 968-1790

Registered specialties

Ambulatory Surgical Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QA1903X

Other Clinic/Center providers in Mississippi →

Registry record

NPI: 1033190129
Entity type: Organization
NPI issued: 7 Nov 2005
Record last updated: 10 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.