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NPI Code Detail

MEDICARE: EMERGENT SURGICAL SERVICES

MEDICARE: EMERGENT SURGICAL SERVICES
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
1246ZC0007XSurgical Assistant

General Provider Information

NPI Number : 1790807931
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENT SURGICAL SERVICES
Provider Business Mailing Address
First Line : 19065 BURLINGTON PL
Second Line :
City : DENVER
State : CO
Zip : 80249-8431
Country : US
Telephone Number : 720-939-4670
Fax Number :
Provider Business Practice Location Address
First Line : 12272 JASPER ST
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80603-7006
Country : US
Telephone Number : 720-939-4670
Fax Number :
Authorized Official
Title or Position : CERTIFIED FIRST ASSISTANT
Name : MR. DWIGHT ADONIS CAMPBELL SR.
Credential :
Telephone Number : 720-939-4670
Provider Enumeration Date : 04/06/2007
Last Update Date : 06/28/2019

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Directions to “EMERGENT SURGICAL SERVICES ” Practice Location

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