Organization
SURGICAL ASSOCIATES PC CRNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAWAT PHRUTTITUM M.D. (OWNER)
(641) 228-1143
Entity
Organization
Contact information
Practice address
801 13TH ST, CHARLES CITY, IA 50616-3443
(641) 228-1143
(641) 228-7621
Mailing address
801 13TH ST, CHARLES CITY, IA 50616-3443
(641) 228-1143
(641) 228-7621
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22789
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0127647
—
IA
Enumeration date
02/09/2007
Last updated
08/22/2020
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