Organization
SURGEON'S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL D LICATA MD (OWNER)
(740) 266-3595
Entity
Organization
Contact information
Practice address
4000 JOHNSON RD FL 2, STEUBENVILLE, OH 43952-2364
(740) 266-5959
(740) 266-5957
Mailing address
4000 JOHNSON RD FL 2, STEUBENVILLE, OH 43952-2364
(740) 266-5959
(740) 266-5957
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18107
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013780000
—
WV
05
—
0416964
—
OH
Enumeration date
07/12/2006
Last updated
02/27/2019
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