Provider Demographics
NPI:1497139422
Name:TOP KNOT SURGICAL ASSISTING
Entity Type:Organization
Organization Name:TOP KNOT SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSFA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CIE
Authorized Official - Middle Name:CHLOEE
Authorized Official - Last Name:PSHIGODA
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:918-808-0583
Mailing Address - Street 1:8409 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-5540
Mailing Address - Country:US
Mailing Address - Phone:918-808-0583
Mailing Address - Fax:
Practice Address - Street 1:8409 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-5540
Practice Address - Country:US
Practice Address - Phone:918-808-0583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty