Provider Demographics
NPI:1336127091
Name:SURGICAL ASSOCIATES OF CANTON, INC.
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF CANTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERHOEFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-455-8000
Mailing Address - Street 1:2600 TUSCARAWAS ST W
Mailing Address - Street 2:SUITE 620
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-4644
Mailing Address - Country:US
Mailing Address - Phone:330-455-8000
Mailing Address - Fax:330-455-6006
Practice Address - Street 1:2600 TUSCARAWAS ST W
Practice Address - Street 2:SUITE 620
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4644
Practice Address - Country:US
Practice Address - Phone:330-455-8000
Practice Address - Fax:330-455-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2354143Medicaid
OHSU9267971Medicare ID - Type Unspecified