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Organization

CHIEF SURGICAL, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HERBERT COUSIN JR. CSA (MANAGER)
(762) 235-4343
Entity
Organization

Contact information

Practice address
80 SEVEN HILLS BLVD STE 101-373, DALLAS, GA 30132-0574
(762) 235-4343
Mailing address
80 SEVEN HILLS BLVD STE 101-373, DALLAS, GA 30132-0574

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
05/25/2024
Last updated
05/25/2024
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