Provider Demographics
NPI:1790701654
Name:PARIS SURGICAL SPECIALISTS, P.L.L.C.
Entity Type:Organization
Organization Name:PARIS SURGICAL SPECIALISTS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-644-3211
Mailing Address - Street 1:235 TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4544
Mailing Address - Country:US
Mailing Address - Phone:731-644-3211
Mailing Address - Fax:731-644-1552
Practice Address - Street 1:235 TYSON AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4544
Practice Address - Country:US
Practice Address - Phone:731-644-3211
Practice Address - Fax:731-644-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNDB4003OtherRAILROAD MEDICARE GROUP
TNDB4003OtherRAILROAD MEDICARE GROUP