Organization
ADVANCED SOUTHERN SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY PEREZ M.D. (MANAGER)
(985) 446-2524
Entity
Organization
Contact information
Practice address
604 N ACADIA RD, SUITE 406, THIBODAUX, LA 70301-4847
(985) 446-2524
(985) 447-2329
Mailing address
604 N ACADIA ROAD, SUITE 406, THIBODAUX, LA 70301
(985) 446-2524
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15745R
LA
Other
Enumeration date
01/08/2007
Last updated
05/25/2011
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