| South Central Regional Medical Center-cardiology | |
|
1220 Jefferson St Laurel MS 39440-4355 | |
| (601) 426-4000 | |
| (601) 399-6254 |
| Full Name | South Central Regional Medical Center-cardiology |
|---|---|
| Speciality | Internal Medicine |
| Location | 1220 Jefferson St, Laurel, Mississippi |
| Authorized Official Name and Position | James T Canizaro (CFO) |
| Authorized Official Contact | 6014264504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Central Regional Medical Center-cardiology Po Box 607 Laurel MS 39441-0607 Ph: (601) 426-4000 | South Central Regional Medical Center-cardiology 1220 Jefferson St Laurel MS 39440-4355 Ph: (601) 426-4000 |
| NPI Number | 1700934676 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 11/02/2010 |
| Medicare PECOS PAC ID | 8325946411 |
|---|---|
| Medicare Enrollment ID | O20031229000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700934676 | NPI | - | NPPES |
| 09013315 | Medicaid | MS | |
| 000019141 | Other | MS | BLUE CROSS OF MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 11-153 (Mississippi) | Primary |
| Provider Name | Herbert G Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720092331 PECOS PAC ID: 6305738576 Enrollment ID: I20040325000372 |
| Provider Name | Wassim E Mouannes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780799965 PECOS PAC ID: 9133199680 Enrollment ID: I20040730000531 |
| Provider Name | Norrapol Wattanasuwan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508801366 PECOS PAC ID: 6800784349 Enrollment ID: I20040921000947 |
| Provider Name | Joseph A Proli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538277843 PECOS PAC ID: 8527002013 Enrollment ID: I20050615000691 |
| Provider Name | Bassam K Mechleb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063625325 PECOS PAC ID: 7911090295 Enrollment ID: I20070831000283 |
| Provider Name | Lisa Kay Bond |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1700890498 PECOS PAC ID: 2769394790 Enrollment ID: I20080107000752 |
| Provider Name | David L Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497702302 PECOS PAC ID: 6002985892 Enrollment ID: I20080520000373 |
| Provider Name | James M Beasley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689696817 PECOS PAC ID: 0547296972 Enrollment ID: I20091204000486 |
| Provider Name | William David Sullivan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659385276 PECOS PAC ID: 2860428299 Enrollment ID: I20091204000521 |
| Provider Name | Charles D Cannon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841214145 PECOS PAC ID: 9537195961 Enrollment ID: I20091217000571 |
| Provider Name | Willus Mark Horne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417961012 PECOS PAC ID: 5890721229 Enrollment ID: I20091217000605 |
| Provider Name | Mark W Norton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881608495 PECOS PAC ID: 2163458597 Enrollment ID: I20091218000235 |
| Provider Name | Amy Delane Adams |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396993663 PECOS PAC ID: 3072782879 Enrollment ID: I20110812000179 |
| Provider Name | Ashlynn Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619345402 PECOS PAC ID: 8123338977 Enrollment ID: I20151105002319 |
| Provider Name | Brittany Carney Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720552268 PECOS PAC ID: 0446664254 Enrollment ID: I20210205000454 |
| Provider Name | Robert W Veith |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750384921 PECOS PAC ID: 3971632100 Enrollment ID: I20210901003760 |
| Provider Name | Sandeep Singh |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902203482 PECOS PAC ID: 2567752413 Enrollment ID: I20210915002363 |
| Provider Name | Cameron Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922756196 PECOS PAC ID: 5496131633 Enrollment ID: I20220926002359 |
Sc Wound Care & Hyperbaric Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Jefferson St, Laurel, MS 39440 Phone: 601-426-4739 Fax: 601-426-4739 | |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-428-6561 | |
Family Health Center Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-422-0431 | |
Jefferson Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 | |
Immediate Care - Laurel Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2313 Highway 15 N, Laurel, MS 39440 Phone: 601-649-2775 Fax: 601-649-2686 | |
South Central Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 | |
South Central Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 |