Basic Information
| Provider Information | |||||||||
| NPI: | 1568579340 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATED SURGICAL SPECIALISTS LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 ARCH ST | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305640728 | ||||||||
| FaxNumber: | 3305640733 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 ARCH ST | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305640728 | ||||||||
| FaxNumber: | 3305640733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 01/03/2009 | ||||||||
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| AuthorizedOfficialLastName: | SLEZAK | ||||||||
| AuthorizedOfficialFirstName: | FREDERICK | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3305640728 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.