Provider Demographics
NPI:1477662559
Name:ADVANCED SURGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ADVANCED SURGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-265-9225
Mailing Address - Street 1:1722 PINE STREET
Mailing Address - Street 2:SUITE 904
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1112
Mailing Address - Country:US
Mailing Address - Phone:334-265-9225
Mailing Address - Fax:334-265-9257
Practice Address - Street 1:1722 PINE STREET
Practice Address - Street 2:SUITE 904
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1112
Practice Address - Country:US
Practice Address - Phone:334-265-9225
Practice Address - Fax:334-265-9257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty