S SONGCHAROEN MD, FACS, PLLC (NPI# 1215100599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215100599 |
| Entity Type | Organization |
| Organization Name | S SONGCHAROEN MD, FACS, PLLC |
| Practice Address |
971 Lakeland Dr Suite 315 Jackson MS 39216-4643 |
| Mailing Address |
971 Lakeland Dr Suite 654 Jackson MS 39216-4643 |
| Practice Telephone | 6019812525 |
| Practice Fax Number | 6019813152 |
| Mailing Telephone | 6019812525 |
| Mailing Fax Number | 6019813152 |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-10-08 |
| Authorized Official Name | SONGCHAROEN SONGCHAROEN (OWNER) |
| Authorized Official Telephone | 6019812525 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | NPI INDIVIDUAL NUMBER | 1689615486 | 01 |
| MS | 00015584 | 05 | |
| MS | RR MEDICARE | 240007802 | 01 |
| MS | BCBS OF MS | 371563401F | 01 |
| Street Address |
971 LAKELAND DR SUITE 315 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661789 | Maurice James | Ophthalmology | 971 Lakeland Dr, Ste 563, Jackson, MS 39216-4607 | 2005-07-01 |
| 1891226643 | Matthew Milling | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Suite 202, Jackson, MS 39216-4643 | 2017-03-23 |
| 1134667843 | Bonney Neill Simmons | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2017-02-02 |
| 1437694320 | Kristen Degelman | Nurse Practitioner | 971 Lakeland Dr, Suite 401, Jackson, MS 39216-4643 | 2016-12-30 |
| 1134671787 | Jackson Thyroid & Endocrine Clinic Pllc | Internal Medicine | 971 Lakeland Dr, Suite 353, Jackson, MS 39216-4643 | 2016-10-31 |
| 1609223205 | Sally Sullivan | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2016-05-24 |
| 1932576998 | Misty Gaines | Nurse Practitioner | 971 Lakeland Dr, Suite 657, Jackson, MS 39216-4643 | 2015-08-26 |
| 1659755676 | Angela B. Mccallum | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2015-07-20 |
| 1356732481 | St Dominic Medical Associates LLC | Internal Medicine | 971 Lakeland Dr, Suite, Jackson, MS 39216-4643 | 2015-02-11 |
| 1689063067 | St Dominic Medical Associates LLC | Urology | 971 Lakeland Dr, Suite 360, Jackson, MS 39216-4643 | 2015-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164484796 | Pramit S Malhotra | Surgery | 900 E Michigan Ave, Ste 108, Jackson, MI 49201-2457 | 2006-04-06 |
| 1043872948 | John Magruder Sullivan IIi | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2019-07-01 |
| 1508352196 | Katherine Christine Benedict | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2018-07-06 |
| 1780121970 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N. East Ave, Jackson, MI 49201 | 2017-01-25 |
| 1437386232 | Emily T Wolfe | Surgery | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-06-18 |
| 1598979064 | Peter B Arnold | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2007-05-10 |
| 1316071145 | John C Payne | Surgery | 555 E Broadway, Suite 211, Jackson, WY 83001 | 2007-03-15 |
| 1063549178 | Plastic Surgery Center, P.a. | Surgery | 1920 Chadwick Dr, Suite 108, Jackson, MS 39204-3471 | 2007-02-27 |
| 1538244579 | John Barry Mccraw | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2006-10-26 |
| 1073695706 | William C Lineaweaver | Surgery | 1850 Chadwick Dr Ste 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2006-10-20 |
| Find all providers in JACKSON | ||||
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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.