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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