Provider Demographics
NPI:1205114998
Name:SOUTHERN MONITORING INNOVATIONS LLC
Entity type:Organization
Organization Name:SOUTHERN MONITORING INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FAY
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:CCP
Authorized Official - Phone:228-392-6406
Mailing Address - Street 1:17398 C J DELLIE RD
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-8707
Mailing Address - Country:US
Mailing Address - Phone:228-392-6406
Mailing Address - Fax:228-396-3272
Practice Address - Street 1:17398 C J DELLIE RD
Practice Address - Street 2:
Practice Address - City:SAUCIER
Practice Address - State:MS
Practice Address - Zip Code:39574-8707
Practice Address - Country:US
Practice Address - Phone:228-392-6406
Practice Address - Fax:228-396-3272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty