| Organization Name: | SURGICAL SPECIALISTS GROUP, LLC |
| NPI Number: | 1043367196 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY ELLIS (ADMINISTRATOR) |
| Mailing Address: | 1323 Summit Drive Jasper |
| State: | AL US |
| Postal Code: | 355010114 |
| Phone Number: | 2052211324 |
| Fax Number: | 2052211325 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 08/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |