Provider Demographics
NPI:1801997994
Name:GATE CITY SURGEONS, PLLC
Entity type:Organization
Organization Name:GATE CITY SURGEONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LINCOLN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-577-3160
Mailing Address - Street 1:280 MAIN ST
Mailing Address - Street 2:SUITE 441
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2919
Mailing Address - Country:US
Mailing Address - Phone:603-577-3160
Mailing Address - Fax:603-577-3199
Practice Address - Street 1:280 MAIN ST
Practice Address - Street 2:SUITE 441
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2919
Practice Address - Country:US
Practice Address - Phone:603-577-3160
Practice Address - Fax:603-577-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30212302Medicaid
RE7034Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER