BRUNSWICK SURGICAL ASSOCIATES, PLLC; NPI #1144206822

Contact Information

BRUNSWICK SURGICAL ASSOCIATES, PLLC

6 DOCTORS CIR
SUITE 1
SUPPLY, NC 28462-4089

Phone: 910-575-4606
Fax: 910-575-4609
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Vascular Surgery	2086S0129X	76	Physician/Peripheral Vascular Disease

Indicates primary specialty

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NPI Profile & details for BRUNSWICK SURGICAL ASSOCIATES, PLLC

NPI # 1144206822

LBN Legal business name BRUNSWICK SURGICAL ASSOCIATES, PLLC

Authorized official MARK TILLOTSON - (PARTNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/15/2005

Last updated 08/22/2020 - About 6 years ago

Identifiers

NC	License #	103114
NC	Medicaid	89015K7

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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