Provider Demographics
NPI:1891782637
Name:AGAPEE SURGICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:AGAPEE SURGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:EDDIE
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-868-2229
Mailing Address - Street 1:607 W DUE WEST AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4420
Mailing Address - Country:US
Mailing Address - Phone:615-868-2229
Mailing Address - Fax:615-868-3635
Practice Address - Street 1:607 W DUE WEST AVE STE 102
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4420
Practice Address - Country:US
Practice Address - Phone:615-868-2229
Practice Address - Fax:615-868-3635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD19524208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty