Provider Demographics
NPI:1952669798
Name:JUTTON SURGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:JUTTON SURGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-822-6175
Mailing Address - Street 1:129 LUBRANO DR
Mailing Address - Street 2:L 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7564
Mailing Address - Country:US
Mailing Address - Phone:443-758-5270
Mailing Address - Fax:410-897-0342
Practice Address - Street 1:129 LUBRANO DR
Practice Address - Street 2:L 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7564
Practice Address - Country:US
Practice Address - Phone:443-758-5270
Practice Address - Fax:410-897-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty