Provider Demographics
NPI:1376771113
Name:MCCOWAN SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:MCCOWAN SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-244-9177
Mailing Address - Street 1:2704 N OAK ST
Mailing Address - Street 2:SUITE A2
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1744
Mailing Address - Country:US
Mailing Address - Phone:229-244-9177
Mailing Address - Fax:229-244-9176
Practice Address - Street 1:2704 N OAK ST
Practice Address - Street 2:SUITE A2
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1744
Practice Address - Country:US
Practice Address - Phone:229-244-9177
Practice Address - Fax:229-244-9176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty