Provider Demographics
NPI:1346352002
Name:COOSA VALLEY SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:COOSA VALLEY SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:CROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-245-8100
Mailing Address - Street 1:209 W SPRING ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2976
Mailing Address - Country:US
Mailing Address - Phone:256-245-8100
Mailing Address - Fax:205-986-0081
Practice Address - Street 1:209 W SPRING ST STE 300
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2976
Practice Address - Country:US
Practice Address - Phone:256-245-8100
Practice Address - Fax:205-986-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty