Provider Demographics
NPI:1144361932
Name:SURGICAL ASSOCIATES, LTD
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-537-4751
Mailing Address - Street 1:433 FRYE FARM RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6480
Mailing Address - Country:US
Mailing Address - Phone:724-537-4751
Mailing Address - Fax:724-537-0259
Practice Address - Street 1:433 FRYE FARM RD
Practice Address - Street 2:SUITE 10
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6480
Practice Address - Country:US
Practice Address - Phone:724-537-4751
Practice Address - Fax:724-537-0259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAM018202-E2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012238240004Medicaid
PAP00164558OtherRAILROAD MEDICARE
PA577282OtherHIGHMARK
PAP00164558OtherRAILROAD MEDICARE
PA0012238240004Medicaid