Provider Demographics
NPI:1942793823
Name:STARKVILLE SURGERY CENTER LLC
Entity Type:Organization
Organization Name:STARKVILLE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:662-320-6555
Mailing Address - Street 1:100 WALKER WAY
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-6607
Mailing Address - Country:US
Mailing Address - Phone:662-320-6555
Mailing Address - Fax:662-320-6566
Practice Address - Street 1:110 WALKER WAY
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-6607
Practice Address - Country:US
Practice Address - Phone:662-320-6555
Practice Address - Fax:662-320-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1689703324OtherGROUP NPI