Organization
SURGICAL ASSIST,L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY J.R. JACOBS C.S.A. (PRESIDENT/CEO)
(804) 239-8208
Entity
Organization
Contact information
Practice address
3913 MORTON DR, RICHMOND, VA 23223-1287
(804) 239-8208
(804) 249-9132
Mailing address
PO BOX 1041, MECHANICSVILLE, VA 23111-1041
(804) 239-8208
(804) 249-9132
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3123
VA
Other
Enumeration date
05/05/2006
Last updated
07/12/2009
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