Provider Demographics
NPI:1689119851
Name:MEDICAL ARTS SURGICAL GROUP
Entity Type:Organization
Organization Name:MEDICAL ARTS SURGICAL GROUP
Other - Org Name:MEDICAL ARTS SURGICAL GROUP RUSH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:TARTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-693-3834
Mailing Address - Street 1:2111 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4041
Mailing Address - Country:US
Mailing Address - Phone:601-693-3834
Mailing Address - Fax:
Practice Address - Street 1:1800 12TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4158
Practice Address - Country:US
Practice Address - Phone:601-703-9223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-27
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty