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NPI Code Detail

MEDICARE: TRI-COUNTY SURGICAL SPECIALISTS LLC

MEDICARE: TRI-COUNTY SURGICAL SPECIALISTS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0102XSurgical Critical Care Physician
2208C00000XColon & Rectal Surgery Physician
3208600000XSurgery Physician

General Provider Information

NPI Number : 1659661544
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-COUNTY SURGICAL SPECIALISTS LLC
Provider Business Mailing Address
First Line : 2000 HEALTH PARK DR
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-4525
Country : US
Telephone Number : 615-372-5426
Fax Number : 843-572-6939
Provider Business Practice Location Address
First Line : 9313 MEDICAL PLAZA DR STE 204
Second Line :
City : CHARLESTON
State : SC
Zip : 29406-9176
Country : US
Telephone Number : 843-797-5151
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : ROBERT FAILE
Credential :
Telephone Number : 843-856-7923
Provider Enumeration Date : 04/12/2011
Last Update Date : 09/02/2021

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Directions to “TRI-COUNTY SURGICAL SPECIALISTS LLC ” Practice Location

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