Provider Demographics
NPI:1598727711
Name:ADVANCED SURGEONS, PC
Entity Type:Organization
Organization Name:ADVANCED SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BLAINE
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:205-595-8985
Mailing Address - Street 1:3686 GRANDVIEW PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3407
Mailing Address - Country:US
Mailing Address - Phone:205-595-8985
Mailing Address - Fax:205-595-8987
Practice Address - Street 1:3686 GRANDVIEW PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3407
Practice Address - Country:US
Practice Address - Phone:205-595-8985
Practice Address - Fax:205-595-8987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529101960Medicaid
AL529101960Medicaid
AL51033791Medicare ID - Type Unspecified
AL51507958Medicare ID - Type Unspecified