Organization
SOUTHERN OHIO SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L KHOURY M.D. (PRESIDENT)
(740) 353-8661
Entity
Organization
Contact information
Practice address
1711 27TH ST, BRAUNLIN BLDG, SUITE 306, PORTSMOUTH, OH 45662-2638
(740) 353-8661
(740) 354-3254
Mailing address
1711 27TH ST, BRAUNLIN BLDG, SUITE 306, PORTSMOUTH, OH 45662-2638
(740) 353-8661
(740) 354-3254
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35-06-5158-K
OH
208600000X
Surgery Physician
Primary
35-84596
OH
363AS0400X
Surgical Physician Assistant
50-00-1711
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0317875
—
OH
05
—
65907073
—
KY
Enumeration date
08/22/2005
Last updated
01/27/2011
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