Provider Demographics
NPI:1992380216
Name:WEST END SURGICAL ASSISTANTS, PLLC
Entity Type:Organization
Organization Name:WEST END SURGICAL ASSISTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA, LSA
Authorized Official - Phone:229-569-5096
Mailing Address - Street 1:10604 CUSSONS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-2634
Mailing Address - Country:US
Mailing Address - Phone:229-569-5096
Mailing Address - Fax:
Practice Address - Street 1:1602 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-5205
Practice Address - Country:US
Practice Address - Phone:229-569-5096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty