Provider Demographics
NPI:1770524563
Name:GETTYSBURG SURGICAL ASSOCIATES INC
Entity type:Organization
Organization Name:GETTYSBURG SURGICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-334-8141
Mailing Address - Street 1:450 S WASHINGTON ST
Mailing Address - Street 2:3RD FLOOR SUITE C
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2500
Mailing Address - Country:US
Mailing Address - Phone:717-334-8141
Mailing Address - Fax:717-334-1885
Practice Address - Street 1:450 S WASHINGTON ST
Practice Address - Street 2:3RD FLOOR SUITE C
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2500
Practice Address - Country:US
Practice Address - Phone:717-334-8141
Practice Address - Fax:717-334-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA083123Medicare PIN