Provider Demographics
NPI:1124410584
Name:SURGICAL SOLUTIONS PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:SURGICAL SOLUTIONS PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUFFICOOL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:605-791-5553
Mailing Address - Street 1:211 FOUNDERS PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8098
Mailing Address - Country:US
Mailing Address - Phone:605-791-5553
Mailing Address - Fax:605-791-5644
Practice Address - Street 1:211 FOUNDERS PARK DR STE B
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8098
Practice Address - Country:US
Practice Address - Phone:605-791-5553
Practice Address - Fax:605-791-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty