NPI 1336263821 · live from the CMS NPI Registry
Advantage Surgical LLC
Physician Assistant, Surgical in Englewood, CO. National Provider Identifier 1336263821, active.
NPI record
| NPI | 1336263821 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 4548 S Bannock St, Englewood, CO 80110 |
| Practice phone | 303-929-1090 |
| Enumerated | March 19, 2007 |
| Last updated | August 22, 2020 |
| Authorized official | Jeffery Garner, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical primary | 363AS0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.