Provider Demographics
NPI:1790103455
Name:A CUT ABOVE SURGICAL ASSISTING LLC
Entity Type:Organization
Organization Name:A CUT ABOVE SURGICAL ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:918-595-2331
Mailing Address - Street 1:6313 E COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-6981
Mailing Address - Country:US
Mailing Address - Phone:918-595-2331
Mailing Address - Fax:918-893-1592
Practice Address - Street 1:6313 E COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-6981
Practice Address - Country:US
Practice Address - Phone:918-595-2331
Practice Address - Fax:918-893-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK140237363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty