Provider Demographics
NPI:1467607267
Name:ACUTE CARE SURGEONS LLC
Entity Type:Organization
Organization Name:ACUTE CARE SURGEONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVANZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-898-5561
Mailing Address - Street 1:477 COOPER RD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8053
Mailing Address - Country:US
Mailing Address - Phone:614-898-5561
Mailing Address - Fax:614-898-5563
Practice Address - Street 1:477 COOPER RD
Practice Address - Street 2:SUITE 440
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8053
Practice Address - Country:US
Practice Address - Phone:614-898-5561
Practice Address - Fax:614-898-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051847174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689618818OtherPERSONAL NPI