South Mississippi Maxillofacial Surgery Center
LBN: South Mississippi Maxillofacial Surgery Center
South Mississippi Maxillofacial Surgery Center is an health care organization with primary practice located at 1760 Medical Park Dr Suite B, Biloxi MS 39532-2131. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty.
South Mississippi Maxillofacial Surgery Center can be contacted via phone (228) 388-5925, or through Watts, Jr, Robert T via phone (228) 388-5925.
Contact Information
Primary practice address
1760 Medical Park Dr Suite B
Biloxi MS 39532-2131
Phone: (228) 388-5925
Fax: (228) 388-8153
Website:
Authorized official contact:
Name: Watts, Jr, Robert T Doctor of Dental Medicine (DMD)
Phone: (228) 388-5925
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | Mississippi |
Profile Details
| NPI number | 1902858004 |
|---|---|
| LBN Legal business name | South Mississippi Maxillofacial Surgery Center |
| DBA Doing business as | |
| Authorized official | Watts, Jr, Robert T Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Aug 22nd, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902858004 | NPPES |
| Mississippi | MEDICAID | 1987800 |
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