Healthcare Provider Details

I. General information

NPI: 1518338052
Provider Name (Legal Business Name): CENTER FOR ADVANCED SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 COMMERCIAL CENTER DRIVE
LADSON SC
29456-4146
US

IV. Provider business mailing address

137 GATEWAY DR
LADSON SC
29456-3552
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-3676
  • Fax: 843-797-3677
Mailing address:
  • Phone: 843-797-3676
  • Fax: 843-797-3677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON M HIGHSMITH
Title or Position: OWNER / DIRECTOR
Credential: M.D.
Phone: 843-553-7615