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Magnolia Surgery Center, LLC

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Company Details

Name: Magnolia Surgery Center, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 09 Jul 2024 (a year ago)
Business ID: 1449183
ZIP code: 39232
County: Rankin
State of Incorporation: MISSISSIPPI
Principal Office Address: 120 Stone Creek Boulevard, Suite 200Flowood, MS 39232
Historical names: Southaven Spine Center, LLC

Agent

Name Role Address
Eric J. Pearson MD Agent 120 Stone Creek Boulevard, Suite 200, Flowood, MS 39232

Organizer

Name Role Address
Joey J. Daugherty Organizer 120 Stone Creek Boulevard, Suite 200, Flowood, MS 39232

National Provider Identifier

NPI Number:
1700685021
Certification Date:
2025-03-10

Authorized Person:

Name:
JAY PAUL MCDONALD
Role:
PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
No
Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Amendment Form Filed 2024-07-12 Amendment For Southaven Spine Center, LLC
Formation Form Filed 2024-07-09 Formation For Southaven Spine Center, LLC

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Date of last update: 06 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website