Provider Demographics
NPI:1285978445
Name:ELITE SURGICAL & ENDOSCOPY SERVICES, PLLC
Entity type:Organization
Organization Name:ELITE SURGICAL & ENDOSCOPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-486-1900
Mailing Address - Street 1:5251-C HIGHWAY 153
Mailing Address - Street 2:#357
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4959
Mailing Address - Country:US
Mailing Address - Phone:423-486-1900
Mailing Address - Fax:423-486-1902
Practice Address - Street 1:5251C HIGHWAY 153
Practice Address - Street 2:#357
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4959
Practice Address - Country:US
Practice Address - Phone:423-486-1900
Practice Address - Fax:423-486-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-12
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty