Provider Demographics
NPI:1588745277
Name:WEST SURGICAL PA
Entity type:Organization
Organization Name:WEST SURGICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:TOM
Authorized Official - Last Name:PEURIFOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-347-9355
Mailing Address - Street 1:101 E BRUNSON ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2526
Mailing Address - Country:US
Mailing Address - Phone:334-347-9355
Mailing Address - Fax:334-393-5057
Practice Address - Street 1:101 E BRUNSON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2526
Practice Address - Country:US
Practice Address - Phone:334-347-9355
Practice Address - Fax:334-393-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty