Organization Name: | LAUREL CLINIC FOR WOMEN |
NPI Number: | 1972828259 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLTON R VINCENT (PHYSICIAN) |
Mailing Address: | 115 S Magnolia St Laurel |
State: | MS US |
Postal Code: | 394404431 |
Phone Number: | 6014287221 |
Fax Number: | 6014287223 |
NPI Enumeration Date: | 03/30/2010 |
NPI Last Update Date: | 03/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 03106 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |