Provider Demographics
NPI:1578253977
Name:EVANSVILLE COLORECTAL SURGERY, LLC
Entity Type:Organization
Organization Name:EVANSVILLE COLORECTAL SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRUFFAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-480-4250
Mailing Address - Street 1:3922 VENETIAN WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-7958
Mailing Address - Country:US
Mailing Address - Phone:812-999-3277
Mailing Address - Fax:812-518-1357
Practice Address - Street 1:3922 VENETIAN WAY STE 2
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7958
Practice Address - Country:US
Practice Address - Phone:812-999-3277
Practice Address - Fax:812-518-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty