Provider Demographics
NPI:1750333753
Name:JACKSON COUNTY SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:JACKSON COUNTY SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:618-687-4891
Mailing Address - Street 1:6 E SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966-7048
Mailing Address - Country:US
Mailing Address - Phone:618-687-4891
Mailing Address - Fax:618-687-4894
Practice Address - Street 1:6 E SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-7048
Practice Address - Country:US
Practice Address - Phone:618-687-4891
Practice Address - Fax:618-687-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty