Provider Demographics
NPI:1821065285
Name:SURGICAL ASSOCIATES. P.C.
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-930-8010
Mailing Address - Street 1:513 BROOKWOOD BLVD
Mailing Address - Street 2:BMP 501
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6862
Mailing Address - Country:US
Mailing Address - Phone:205-930-8010
Mailing Address - Fax:205-930-8014
Practice Address - Street 1:513 BROOKWOOD BLVD
Practice Address - Street 2:BPM 501
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6862
Practice Address - Country:US
Practice Address - Phone:205-930-8010
Practice Address - Fax:205-930-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH065Medicare PIN
ALCA0002Medicare PIN