Provider Demographics
NPI:1215034319
Name:JASPER SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:JASPER SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-482-4494
Mailing Address - Street 1:721 W 13TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-1817
Mailing Address - Country:US
Mailing Address - Phone:812-482-4494
Mailing Address - Fax:482-482-4499
Practice Address - Street 1:721 W 13TH ST STE 220
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1817
Practice Address - Country:US
Practice Address - Phone:812-482-4494
Practice Address - Fax:482-482-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty