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General NPI Number Information
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NPI Number | 1710479191
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Entity Type | Organization
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Legal Business Name | UNITED SURGICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 2150 ASSOCIATION DR
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City | OKEMOS
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State | MI
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Zip | 48864-4909
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Country | US
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Telephone | 517-580-7733
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Fax | 517-580-7639
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Provider Business Mailing Address
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Address Line | 2150 ASSOCIATION DR
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City | OKEMOS
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State | MI
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Zip | 48864-4909
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Country | US
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Telephone | 517-580-7733
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Fax | 517-580-7639
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN ALFRED CARR
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Credential | MD
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Telephone | 517-580-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 4301067523
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License Number State | MI
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