Provider Demographics
NPI:1174846562
Name:SURGEON & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SURGEON & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:SURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-733-0617
Mailing Address - Street 1:1125 PONY DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9159
Mailing Address - Country:US
Mailing Address - Phone:910-733-0617
Mailing Address - Fax:850-515-0260
Practice Address - Street 1:129 WALLACE RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2434
Practice Address - Country:US
Practice Address - Phone:910-733-0617
Practice Address - Fax:850-515-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty