MEDICARE: LANCASTER SURGICAL ASSOCIATES, INC.

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
1	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952319246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCASTER SURGICAL ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	2405 N COLUMBUS ST
Second Line	:	SUITE 250
City	:	LANCASTER
State	:	OH
Zip	:	43130-8185
Country	:	US
Telephone Number	:	740-654-6213
Fax Number	:	740-654-3346

Provider Business Practice Location Address
First Line	:	819 STATE ROUTE 664 N
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-8540
Country	:	US
Telephone Number	:	740-654-6213
Fax Number	:	740-654-3346

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCOTT O JOHNSON
Credential	:	M.D.
Telephone Number	:	740-654-6213

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	10/19/2007

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