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Organization
SURGICAL UNION, LLC
Active
Organization
SURGICAL UNION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM DELONG (PAMS NPI ADMINISTRATOR)
(210) 598-2800
Entity
Organization
Contact information
Practice address
1060 E COUNTY LINE RD STE 3A # 336, RIDGELAND, MS 39157-1937
(601) 282-9595
Mailing address
1060 E COUNTY LINE RD STE 3A # 336, RIDGELAND, MS 39157-1937
(601) 282-9595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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