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General NPI Number Information
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NPI Number | 1477998466
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Entity Type | Organization
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Legal Business Name | SEACOAST SURGERY LLC
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Dates
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Enumeration Date | 05/03/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 16 HOSPITAL DR SUITE B
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-8117
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Fax | 207-351-8098
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Provider Business Mailing Address
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Address Line | 16 HOSPITAL DR SUITE B
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-351-8117
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Fax | 207-351-8098
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Authorized Official
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Title or Position | OWNER/SURGEON
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Name | DR. JEFFREY P THURLOW
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Credential | MD
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Telephone | 207-752-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 016049
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License Number State | ME
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