SOUTHEAST UROGYN LLC


Address: 501 Marshall St, Suite 600, Jackson, MS 39202-1651
Phone: 6019486540

SOUTHEAST UROGYN LLC (NPI# 1548513617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548513617
Entity Type Organization
Organization Name SOUTHEAST UROGYN LLC
Practice Address 501 Marshall St
Suite 600
Jackson
MS 39202-1651
Practice Telephone 6019486540
Practice Fax Number 6013261501
Mailing Telephone 6019486540
Mailing Fax Number 6013261501
Enumeration Date 2012-10-26
Last Update Date 2016-01-20
Authorized Official Name MRS. JULIE FERGUSON (ADMINISTRATOR)
Authorized Official Telephone 6019486540
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207V00000X Obstetrics & Gynecology Allopathic & Osteopathic Physicians
Y 207VF0040X Obstetrics & Gynecology
Specialization: Female Pelvic Medicine and Reconstructive Surgery
Allopathic & Osteopathic Physicians

Office Location

Street Address 501 MARSHALL ST
SUITE 600
City JACKSON
State MS
Zip Code 39202-1651

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932176641 Sabra Sullivan Dermatology 501 Marshall St, Suite 606, Jackson, MS 39202-1651 2006-03-01
1598328684 Caroline Douglass Peeples Registered Nurse 501 Marshall St, Jackson, MS 39202-1651 2019-04-15
1548655053 Mississippi Urology Outpatient Surgery Center, LLC Clinic/Center 501 Marshall St, Suite 201, Jackson, MS 39202-1651 2015-04-01
1639586076 Baptist Heart Internal Medicine 501 Marshall St, Suite 104, Jackson, MS 39202-1651 2014-07-17
1568709574 Medical Foundation of Central Ms Surgery 501 Marshall St, Suite 500, Jackson, MS 39202-1651 2013-01-10
1417291451 Urogyn Diagnostics LLC Obstetrics & Gynecology 501 Marshall St, Suite 600, Jackson, MS 39202-1651 2012-11-15
1477825800 The Medical Foundation of Central Mississippi Clinic/Center 501 Marshall St, Suite 100, Jackson, MS 39202-1651 2012-02-01
1265712145 Laurie Selman Nimon Nurse Practitioner 501 Marshall St, Suite 600, Jackson, MS 39202-1651 2011-08-23
1992034771 Southeast Urogynecology Pa Urology 501 Marshall St, Suite 607-a, Jackson, MS 39202-1651 2009-12-08
1053646877 Barrie E Aden Audiologist 501 Marshall St, Suite 602, Jackson, MS 39202-1651 2009-10-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982234183 Eva Mackenzie Carmody Physician Assistant 1190 N State St Suite 502, Jackson, MS 39202 2020-01-16
1750868691 Katherine Walters Nurse Practitioner 501 Marshall St., Suite 400, Jackson, MS 39202 2018-07-24
1932638749 Tylan Lee Social Worker 860 East River Place Suite 100, Jackson, MS 39202 2017-06-06
1417314725 Euna Jyles Counselor 860 E River Pl, Jackson, MS 39202 2016-01-19
1255712048 Edward Jonathan Breight Specialist/Technologist 1325 East Fortication Street, Jackson, MS 39202 2015-06-17
1881037703 Kara Spinks Logan Surgery 1190 N State St Ste 502, Jackson, MS 39202 2013-04-10
1477876530 Mick Inc. Technician 334 Josanna Street, Suite #209, Jackson, MS 39202 2010-03-03
1073724910 Paul Frederic Dare Anesthesiology 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 2007-05-24
1225247703 Lynn Kincannon Holland Counselor 911 Manship Street, Unit A, Jackson, MS 39202 2007-05-22
1457568149 Incare Inc Pulmonary Function Technologist 1151 North State St, Suite 406, Jackson, MS 39202 2007-05-16
Find all providers in zip 39202

Taxonomy Information

Taxonomy Code 207VF0040X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology
Specialization Female Pelvic Medicine and Reconstructive Surgery

Taxonomy Definition

A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962679241 Paul H Moore IIi Obstetrics & Gynecology 2500 North State Street, Jackson, MS 39216-4500 2008-05-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1548688310 Ovation Womens Wellness LLC Obstetrics & Gynecology 111 Colony Crossing Way Ste 230, Madison, MS 39110-6833 2014-03-31
1902807878 Thomas Clifton Pitman Obstetrics & Gynecology 7736 Airways Blvd, Southaven, MS 38671-5306 2005-08-02

Competitor

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City JACKSON
Zip Code 39202

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Dataset Information

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.

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