Provider Demographics
NPI:1710132386
Name:GEM CITY ACUTE SURGICAL CARE CONSULTANTS, INC.
Entity Type:Organization
Organization Name:GEM CITY ACUTE SURGICAL CARE CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:DE CAESTECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-534-0154
Mailing Address - Street 1:PO BOX 292185
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-0185
Mailing Address - Country:US
Mailing Address - Phone:937-534-0154
Mailing Address - Fax:937-534-0166
Practice Address - Street 1:1035 HIDDEN RIDGE LN
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3232
Practice Address - Country:US
Practice Address - Phone:937-534-0154
Practice Address - Fax:937-435-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Single Specialty