General Surgery Of Southaven Llc

LBN: General Surgery Of Southaven Llc
General Surgery Of Southaven Llc is an health care organization with primary practice located at 401 Southcrest Cir Suite 210, Southaven MS 38671-6726. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. General Surgery Of Southaven Llc can be contacted via phone (662) 536-1944, or through Fore, Daniel Benjamin via phone (662) 536-1944.

Contact Information

Primary practice address
401 Southcrest Cir Suite 210 Southaven MS 38671-6726
Phone: (662) 536-1944
Fax: (662) 536-1947
Website:
Map and Directions
Authorized official contact:
Name: Fore, Daniel Benjamin Doctor of Medicine (MD)
Phone: (662) 536-1944

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X

Profile Details

NPI number 1164535415
LBN Legal business name General Surgery Of Southaven Llc
DBA Doing business as
Authorized official Fore, Daniel Benjamin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2006
Last updated Mar 24th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164535415 NPPES
Mississippi MEDICAID 03873250

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