Mississippi Anesthesia Group, LLC
NPI #1366845554 in Canton, Mississippi
Provider Information
- NPI Number
- 1366845554
- Entity Type
- Organization
- Organization Name
- Mississippi Anesthesia Group, LLC
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Enumeration Date
- Oct 1, 2014
- Last Updated
- Oct 1, 2014
Practice Location
- Address
- 145 SANCTUARY LN
- City
- Canton
- State
- Mississippi
- ZIP Code
- 39046-6601
- Phone
- (601) 855-7440
Authorized Official
- Name
- GARY DWAYNE SELF, CRNA
- Title
- FOUNDER AND PRESIDENT
- Phone
- (601) 668-5628
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
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