Provider Demographics
NPI:1033755319
Name:REGIONAL SURGICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:REGIONAL SURGICAL SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-622-0602
Mailing Address - Street 1:210 E LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3657
Mailing Address - Country:US
Mailing Address - Phone:229-938-1097
Mailing Address - Fax:
Practice Address - Street 1:210 E LAMAR ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3657
Practice Address - Country:US
Practice Address - Phone:229-938-1097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery