# CHIEF SURGICAL, L.L.C.

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

## Provider details

- **NPI number:** 1548000813
- **Authorized official:** HERBERT COUSIN JR. CSA (MANAGER)
- **Authorized official phone:** (762) 235-4343

## Contact information

- **Practice address:** 80 SEVEN HILLS BLVD STE 101-373, DALLAS, GA 30132-0574
- **Practice address phone:** (762) 235-4343
- **Mailing address:** 80 SEVEN HILLS BLVD STE 101-373, DALLAS, GA 30132-0574

## Taxonomy

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

## Other

- **Enumeration date:** 05/25/2024
- **Last updated:** 05/25/2024