Desoto Surgery Clinic LLC
NPI #1528074184 in Southaven, Mississippi
Provider Information
- NPI Number
- 1528074184
- Entity Type
- Organization
- Organization Name
- Desoto Surgery Clinic LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Aug 1, 2006
- Last Updated
- Mar 14, 2008
Practice Location
- Address
- 7580 CLARINGTON CV
- City
- Southaven
- State
- Mississippi
- ZIP Code
- 38671
- Phone
- (662) 536-1545
Authorized Official
- Name
- MICHAEL E FOSTER, MD
- Title
- MEDICAL DIRECTOR
- Phone
- (662) 536-1545
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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