Provider Demographics
NPI:1982084562
Name:CJ SURGICAL ASSISTING
Entity Type:Organization
Organization Name:CJ SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C
Authorized Official - Phone:520-390-3862
Mailing Address - Street 1:9420 E. GOLF LINKS RD.
Mailing Address - Street 2:STE 108 #138
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85873-1317
Mailing Address - Country:US
Mailing Address - Phone:520-390-3862
Mailing Address - Fax:
Practice Address - Street 1:9420 E. GOLF LINKS RD.
Practice Address - Street 2:STE 108 #138
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1317
Practice Address - Country:US
Practice Address - Phone:520-390-3862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty