# ADVANCED SURGICAL ASSISTANTS LLC

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

## Provider details

- **NPI number:** 1487027504
- **Authorized official:** MR. ROBERT LEE GILLUM JR. SFA (SURGICAL FIRST ASSISTANT)
- **Authorized official phone:** (228) 343-3044

## Contact information

- **Practice address:** 1924 30TH AVE STE A, GULFPORT, MS 39501-4534
- **Practice address phone:** (228) 206-7634
- **Practice address fax:** (228) 206-4523
- **Mailing address:** 1924 30TH AVE STE A, GULFPORT, MS 39501-4534
- **Mailing address phone:** (228) 206-7634
- **Mailing address fax:** (228) 206-4523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | MS | Yes |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 11/11/2015