Basic Information
| Provider Information | |||||||||
| NPI: | 1912930660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SURGICAL ASSOCIATES OF NE KS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E 10TH ST | ||||||||
| Address2: | |||||||||
| City: | WACONIA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553874552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524429770 | ||||||||
| FaxNumber: | 9524423620 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 UTAH ST | ||||||||
| Address2: | |||||||||
| City: | HIAWATHA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664342314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7857422131 | ||||||||
| FaxNumber: | 9524423620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 03/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | SINNING | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7857422131 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.