NPI 1114353539

South Central Regional Medical Center

Organisation Dermatology Physician Waynesboro, MS

Practice location

Address: 920 Matthew Dr Suite 8, Waynesboro, MS 39367-2553
Phone: (601) 425-7583
Fax: (601) 399-6281
Mailing address: PO Box 1649, Laurel, MS 39441-1649

Authorised official

Name: James T Canizaro
Title: Vp of Finance/Cfo
Phone: (601) 399-6139

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Mississippi →

Registry record

NPI: 1114353539
Entity type: Organization
NPI issued: 17 Sep 2013
Record last updated: 17 Sep 2013

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.