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Organization
ADVANCED SURGICAL ASSISTANTS LLC
Active
Organization
ADVANCED SURGICAL ASSISTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEE GILLUM JR. SFA (SURGICAL FIRST ASSISTANT)
(228) 343-3044
Entity
Organization
Contact information
Practice address
1924 30TH AVE STE A, GULFPORT, MS 39501-4534
(228) 206-7634
(228) 206-4523
Mailing address
1924 30TH AVE STE A, GULFPORT, MS 39501-4534
(228) 206-7634
(228) 206-4523
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
MS
Other
Enumeration date
11/11/2015
Last updated
11/11/2015
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