Provider Demographics
NPI:1831474105
Name:SURGERY OF LONDON, INC.
Entity Type:Organization
Organization Name:SURGERY OF LONDON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-490-7244
Mailing Address - Street 1:54 W HIGH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1075
Mailing Address - Country:US
Mailing Address - Phone:740-490-7244
Mailing Address - Fax:740-490-7362
Practice Address - Street 1:54 W HIGH ST
Practice Address - Street 2:SUITE A
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1075
Practice Address - Country:US
Practice Address - Phone:740-490-7244
Practice Address - Fax:740-490-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty