SOUTH CENTRAL CLINICS, INC (NPI# 1073828455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073828455 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL CLINICS, INC |
| Other Organization Name | SOUTH CENTRAL DERMATOLOGY CLINIC |
| Practice Address |
1410 Jefferson St Laurel MS 39440-4243 |
| Mailing Address |
Po Box 247 Laurel MS 39441-0247 |
| Practice Telephone | 6014254860 |
| Practice Fax Number | 6014264993 |
| Mailing Telephone | 6014257550 |
| Mailing Fax Number | 6013996281 |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | MONICA MORROW (DIRECTOR CLINIC SUPPORT) |
| Authorized Official Telephone | 6013996167 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| South Central Dermatology Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508273335 | South Central Clinics, Inc | Pain Medicine | 2002 Highway 15 N Ste D, Laurel, MS 39440-1983 | 2014-07-14 |
| 1134558331 | South Central Clinics, Inc | Dermatology | 920 Matthew Dr Ste 8, Waynesboro, MS 39367-2553 | 2013-11-07 |
| 1972888659 | South Central Clinics, Inc | Family Medicine | 109 N. Front St, Sandersville, MS 39477 | 2011-10-13 |
| 1801835087 | South Central Clinics, Inc | Internal Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-05 |
| 1861037749 | South Central Clinics, Inc | Clinic/Center | 1008 N 15th Ave, Laurel, MS 39440-2656 | 2019-11-14 |
| 1093232506 | South Central Clinics, Inc | Psychiatry & Neurology | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| 1457878969 | South Central Clinics, Inc | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| 1376060830 | South Central Clinics, Inc | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| 1346767852 | South Central Clinics, Inc | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| 1821515388 | South Central Clinics, Inc | Clinic/Center | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| Street Address |
1410 JEFFERSON ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003006602 | Hossein Nasajpour | Plastic Surgery | 1410 Jefferson St, Laurel, MS 39440-4243 | 2007-07-30 |
| 1710502661 | Laurel Plastic Surgery LLC | Ophthalmology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2020-06-16 |
| 1316480320 | Kristina Molnar | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2016-11-22 |
| 1093180531 | Kimberly Kennedy | Registered Nurse | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-12-09 |
| 1639547425 | Brandi Tynes | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-09-10 |
| 1619345402 | Ashlynn Bennett | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-09-10 |
| 1023358132 | South Central Regional Medical Center | Radiology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2013-02-26 |
| 1821362385 | Lauren S Aycock | Registered Nurse | 1410 Jefferson St, Laurel, MS 39440-4243 | 2012-03-01 |
| 1841581352 | South Central Cinics, Inc | Surgery | 1410 Jefferson St, Laurel, MS 39440-4243 | 2011-05-02 |
| 1396993663 | Amy Adams | Dermatology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2008-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891976908 | Cylburn Earl Soden Jr. | Dermatology | 13920 Baltimore Ave, Laurel, MD 20707-5009 | 2007-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578583514 | Terry Westmoreland | Dermatology | 2110 5th St N, Columbus, MS 39705-2210 | 2006-07-20 |
| 1497159453 | Pine Belt Dermatology and Skin Cancer Center | Dermatology | 201 S Main St, Petal, MS 39465-2362 | 2014-10-20 |
| 1194124834 | David B Roy Do Pa | Dermatology | 201 S Main St, Petal, MS 39465-2362 | 2014-08-19 |
| 1912166703 | William H Black | Dermatology | 2500 N State St, Jackson, MS 39216-4500 | 2008-06-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.