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General NPI Number Information
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NPI Number | 1588182893
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Entity Type | Organization
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Legal Business Name | NEXGEN SURGICAL LLC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 500 CHERRY ST
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City | BLUEFIELD
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State | WV
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Zip | 24701-3306
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Country | US
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Telephone | 954-570-0337
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Fax |
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Provider Business Mailing Address
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Address Line | 1765 E NINE MILE RD STE 1-229
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City | PENSACOLA
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State | FL
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Zip | 32514-5479
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Country | US
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Telephone | 410-429-6115
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Fax |
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | KURT ZUMWALT
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Credential |
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Telephone | 410-404-6815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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