Provider Demographics
NPI:1700941796
Name:SURGICAL SPECIALISTS OF YORK LTD
Entity Type:Organization
Organization Name:SURGICAL SPECIALISTS OF YORK LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-812-8871
Mailing Address - Street 1:1777 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2632
Mailing Address - Country:US
Mailing Address - Phone:717-812-8871
Mailing Address - Fax:717-812-8624
Practice Address - Street 1:1777 5TH AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2632
Practice Address - Country:US
Practice Address - Phone:717-812-8871
Practice Address - Fax:717-812-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S009169L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017934790003Medicaid
H12172Medicare UPIN
PA124378Medicare PIN