Provider Demographics
NPI:1518338052
Name:CENTER FOR ADVANCED SURGERY LLC
Entity type:Organization
Organization Name:CENTER FOR ADVANCED SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIGHSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-553-7615
Mailing Address - Street 1:137 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-3552
Mailing Address - Country:US
Mailing Address - Phone:843-797-3676
Mailing Address - Fax:843-797-3677
Practice Address - Street 1:3821 COMMERCIAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4146
Practice Address - Country:US
Practice Address - Phone:843-797-3676
Practice Address - Fax:843-797-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical