PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.

OKATIE, SC
NPI1083862882
Doing Business AsACI SURGICAL ASSOCIATES
Entity TypeOrganization
Authorized ContactROBIN J. MADDOX
Provider Enrollment COO Rdinator
912-350-9335
Organization Subpart ?No
Primary Taxonomy2086X0206X Surgery Surgical Oncology
Additional Taxonomies207VX0201X Obstetrics & Gynecology Gynecologic Oncology
207Y00000X Otolaryngology
208600000X Surgery
2086S0102X Surgery Surgical Critical Care
Enumeration Date2008-09-04
Last Update Date2011-05-03
Business Address
PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.
14 OKATIE CENTER BLVD. SOUTH SUITE 101
OKATIE, SC 29909
Phone number: 912-350-2299
Mailing Address
PROVIDENT HEALTH SURGICAL ASSOCIATES, INC.
PO BOX 102019
ATLANTA, GA 30368-2019
Phone number: 912-350-2299