Provider Demographics
NPI:1023548302
Name:SMYTH COUNTY SURGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SMYTH COUNTY SURGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:276-378-0075
Mailing Address - Street 1:239 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4103
Mailing Address - Country:US
Mailing Address - Phone:276-378-0075
Mailing Address - Fax:855-318-0701
Practice Address - Street 1:239 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354
Practice Address - Country:US
Practice Address - Phone:315-297-9339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty