OrganizationActive
South Central Regional Medical Center
NPI 1821342379 · Pediatric Adolescent Medicine Physician · Laurel, MS
Provider details
- NPI number
- 1821342379
- Entity type
- Organization
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- James Canizaro, Vice President/ C.f.o.(601) 399-6139
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
234 S 12th Ave
Laurel, MS 39440-4325
Phone: (601) 649-3520
Fax: (601) 649-7899
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1649
Laurel, MS 39441-1649
Other names (DBA / former)
- Doing business as
- Laurel Pediatric Clinic
Registry dates
- Enumerated
- 2012-11-06
- Last updated
- 2012-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.