# ENT SURGERY ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356682033
- **Authorized official:** JOHN JAMOULIS JAMESON M.D. (OWNER)
- **Authorized official phone:** (617) 499-9933

## Contact information

- **Practice address:** 725 CONCORD AVE, 2300, CAMBRIDGE, MA 02138-1040
- **Practice address phone:** (617) 499-9933
- **Practice address fax:** (617) 499-9935
- **Mailing address:** 725 CONCORD AVE, 2300, CAMBRIDGE, MA 02138-1040
- **Mailing address phone:** (617) 499-9933
- **Mailing address fax:** (617) 499-9935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | 72421 | MA | Yes |

## Other

- **Enumeration date:** 03/06/2013
- **Last updated:** 03/06/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110049047 | — | MA |