Family Medicine
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1942554761 · enumerated 2012-10-31 · record updated 2012-10-31. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mr. JAMES CANIZARO, C.F.O. / Vice President · (601) 399-6139
Other names: ELLISVILLE MEDICAL CLINIC
Addresses and phones
- Mailing address 1203 AVENUE B, ELLISVILLE, MS, 39437-2080 (601) 477-8553 Fax (601) 477-9158 Google Maps Apple Maps OpenStreetMap
- Practice location 1203 AVENUE B, ELLISVILLE, MS, 39437-2080 (601) 477-8553 Fax (601) 477-9158 Google Maps Apple Maps OpenStreetMap
Specialties
- Obstetrics & Gynecology 207V00000X
- Pediatrics, Adolescent Medicine 2080A0000X
- Family Medicine 207Q00000X · Primary
In this directory
Locations and evidence
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Practice location
ELLISVILLE, MS, 394372080
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.